Provider Demographics
NPI:1124642582
Name:MCCURRY, AMANDA LANE (FNP-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LANE
Last Name:MCCURRY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LANE
Other - Last Name:MCCURRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1000 URBAN CENTER DR
Mailing Address - Street 2:STE 600
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2584
Mailing Address - Country:US
Mailing Address - Phone:423-439-4381
Mailing Address - Fax:
Practice Address - Street 1:1276 GILBREATH DR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37614-6503
Practice Address - Country:US
Practice Address - Phone:423-439-7184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN194338163W00000X
TN27680363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse