Provider Demographics
NPI:1386938611
Name:APPLING, AMANDA GILLELAND (PA-C)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:GILLELAND
Last Name:APPLING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3970 DEPUTY BILL CANTRELL MEMORIAL RD.
Mailing Address - Street 2:ST 203
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040
Mailing Address - Country:US
Mailing Address - Phone:770-887-5159
Mailing Address - Fax:779-887-9496
Practice Address - Street 1:3970 DEPUTY BILL CANTRELL MEMORIAL RD.
Practice Address - Street 2:STE 203
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040
Practice Address - Country:US
Practice Address - Phone:770-887-5159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7295363A00000X
FLPA9106009363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA7295OtherSTATE LICENSE