Provider Demographics
NPI:1316818669
Name:BORDEN, AMANDA BROOKE
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:BROOKE
Last Name:BORDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 ALCOA HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1543
Mailing Address - Country:US
Mailing Address - Phone:865-305-5622
Mailing Address - Fax:865-305-4580
Practice Address - Street 1:1926 ALCOA HWY STE 200
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1543
Practice Address - Country:US
Practice Address - Phone:865-305-5622
Practice Address - Fax:865-305-4580
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN104622932363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health