Provider Demographics
NPI:1932756129
Name:DANZ, AMANDA K (NP-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:K
Last Name:DANZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 HOSPITAL BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-0001
Mailing Address - Country:US
Mailing Address - Phone:470-321-7500
Mailing Address - Fax:678-355-4474
Practice Address - Street 1:4500 HOSPITAL BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-0001
Practice Address - Country:US
Practice Address - Phone:470-321-7500
Practice Address - Fax:678-355-4474
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN204892363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner