Individual
MRS. AMANDA MCNULTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
308 BEDELL AVE, WOODBINE, GA 31569-2091
(912) 576-5999
(912) 576-5888
Mailing address
107 CYPRESS BND, KINGSLAND, GA 31548-5642
(904) 557-4306
(912) 576-5888
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN218786
GA
Other
Enumeration date
04/09/2014
Last updated
07/07/2014
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