Individual
AMANDA FONDREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
34 GLENWOOD DR, COLUMBUS, MS 39705-1596
(662) 570-1166
(662) 570-1185
Mailing address
34 GLENWOOD DR, COLUMBUS, MS 39705-1596
(662) 570-1166
(628) 570-1185
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R858548
MS
Other
Enumeration date
09/11/2014
Last updated
03/06/2023
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