Individual
AMANDA PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1599 2ND AVE, CHARLESTON, WV 25387-2514
(304) 453-4663
(304) 453-1103
Mailing address
PO BOX 20112, CHARLESTON, WV 25362-1112
(304) 453-4663
(304) 453-1103
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5249334
FL
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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