Provider Demographics
NPI:1972196699
Name:THOMAS, AMANDA ADELLE (APRN AGACNP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:ADELLE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:APRN AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 DICKERSON PIKE STE 580
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-2526
Mailing Address - Country:US
Mailing Address - Phone:615-860-1040
Mailing Address - Fax:
Practice Address - Street 1:3443 DICKERSON PIKE STE 580
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2526
Practice Address - Country:US
Practice Address - Phone:615-860-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-13
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28985363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology