Most Relevant Information
Provider Data
| NPI Number: | 1003282450 |
| Provider Name: | AMANDA LOUANNE MILLS GANN APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 3010059 |
Most Important Dates
| Enumeration Date: | 08/19/2015 |
| Last Updated: | 10/15/2024 |
Provider Practice Location
121 W VIRGINIA AVE
PINEVILLE
KY
409771661
Practice Location Phone/Fax
| Phone: | 6066542412 |
| Fax: | 6066542519 |
Provider Mailing Location
121 W VIRGINIA AVE STE 100
PINEVILLE
KY
409771600
Provider Mailing Phone/Fax
| Phone: | 6066542412 |
| Fax: | 6066542519 |