Provider Demographics
NPI:1093494445
Name:WEBB, AMANDA DANYELLE (PMHNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:DANYELLE
Last Name:WEBB
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 DRY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:TN
Mailing Address - Zip Code:37846-2217
Mailing Address - Country:US
Mailing Address - Phone:865-441-0359
Mailing Address - Fax:
Practice Address - Street 1:129 N LOCUST AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-3757
Practice Address - Country:US
Practice Address - Phone:931-762-7232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5021731363LP0808X
KY4031772363LP0808X
TN34280363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health