Individual provider · Type 1 NPI
Amanda Gayle Petty, APRN
Primary Care Nurse Practitioner · Waycross, GA
NPI number
1174301386
Active
Practice location
3620 Harris Rd
Waycross, GA 31503-0311
Mailing address
156 Elizabeth St
Folkston, GA 31537-2926
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | RN222648 (GA) |
Primary Care Nurse Practitioner: Definition to come...
About NPI 1174301386
Amanda Gayle Petty, APRN's National Provider Identifier is 1174301386, issued on Sep 19, 2023. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Waycross, GA. The record was last updated on Sep 19, 2023.