Individual
AMANDA DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1550 KENNESAW DUE WEST RD NW, KENNESAW, GA 30152-4338
(470) 956-7716
Mailing address
1550 KENNESAW DUE WEST RD NW, KENNESAW, GA 30152-4338
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN283355
GA
Other
Enumeration date
07/11/2025
Last updated
10/25/2025
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