Smith, Amanda S
Smith, Amanda S is an individual health care provider with primary practice located at 700 Riverside Ave , Waycross GA 31501-5358. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Smith, Amanda S can be contacted via phone (912) 490-8546.Contact Information
Primary practice address
700 Riverside Ave
Waycross GA 31501-5358
Phone: (912) 490-8546
Fax: (877) 221-0052
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA9103832 | Florida |
Profile Details
| NPI number | 1316043227 |
|---|---|
| LBN Legal business name | Smith, Amanda S |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 16th, 2006 |
| Last updated | Dec 26th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316043227 | NPPES |
| Florida | MEDICAID | 292817500 | |
| Florida | MEDICAID | 003130352C |
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