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Individual

MRS. AMANDA JILL TRAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1920 KIRBY PKWY, SUITE 100, GERMANTOWN, TN 38138-3696
(901) 751-0050
Mailing address
2646 FALL SPRING DR, OLIVE BRANCH, MS 38654-9476
(901) 359-5409

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
16198
TN
363LP0200X
Pediatric Nurse Practitioner
16198
TN

Other

Enumeration date
11/09/2011
Last updated
11/20/2025
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