Individual
AMY CHRISTINE VARDAMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3788 IDLEWILD PL, SUWANEE, GA 30024-4619
(404) 273-5225
Mailing address
3788 IDLEWILD PL, SUWANEE, GA 30024-4619
(404) 273-5225
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
RN150639
GA
363LF0000X
Family Nurse Practitioner
Primary
RN150639
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52058526
BCBS ID #
GA
Enumeration date
01/11/2007
Last updated
11/30/2016
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