Most Relevant Information
Provider Data
| NPI Number: | 1003256496 |
| Provider Name: | AMANDA WILSON FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | APN0000017457 |
Most Important Dates
| Enumeration Date: | 06/28/2013 |
| Last Updated: | 08/08/2014 |
Provider Practice Location
472 W POPLAR AVE
101
COLLIERVILLE
TN
380172538
Practice Location Phone/Fax
| Phone: | 9018545771 |
| Fax: |
Provider Mailing Location
PO BOX 381071
GERMANTOWN
TN
381831071
Provider Mailing Phone/Fax
| Phone: | 9017545633 |
| Fax: |