Amanda Michele Wilson
Nurse Practitioner, Family in Gadsden, AL. Individual provider (NPI-1).
NPI number1760104590
StatusActive
Last updated in NPPESAug 15, 2024
Details
- NPI
- 1760104590
- Entity type
- Individual (NPI-1)
- Name
- Amanda Michele Wilson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 19, 2022
- Certification date
- Aug 15, 2024
- Last updated
- Aug 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 1-155376 | AL | Yes |
Other names
- Amanda Michele Lewis (Former Name)
Practice location
1007 Goodyear AveGadsden, AL 35903-1100
Phone 256-494-4000
Mailing address
205 Owens DrGadsden, AL 35904-7161
Phone 256-717-7175
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