Provider Demographics
NPI:1306667472
Name:ROGERS-BECKLEY, AMANDA M (RN, NC-BC)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:M
Last Name:ROGERS-BECKLEY
Suffix:
Gender:F
Credentials:RN, NC-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#201
Mailing Address - Street 2:4400 BROWNSVILLE RD STE #105
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-4035
Mailing Address - Country:US
Mailing Address - Phone:470-922-3838
Mailing Address - Fax:
Practice Address - Street 1:5711 CHANTA LN
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-4035
Practice Address - Country:US
Practice Address - Phone:470-922-3838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN315395163WC0200X, 171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine