Provider Demographics
NPI:1992424527
Name:CHITWOOD, AMANDA (FNP-BC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:CHITWOOD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 JACKSBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:JACKSBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37757-4850
Mailing Address - Country:US
Mailing Address - Phone:423-201-9937
Mailing Address - Fax:
Practice Address - Street 1:7200 STRAWBERRY PLAINS PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37914-9589
Practice Address - Country:US
Practice Address - Phone:865-240-3038
Practice Address - Fax:855-576-2235
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32068363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner