MEDICARE: AMANDA THERESA HARPER FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN-NP227224	GA
2	363LF0000X	Family Nurse Practitioner	116888	NE
3	363LF0000X	Family Nurse Practitioner	APRN11046973	FL

General Provider Information

NPI Number	:	1598294159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA THERESA HARPER FNP-C

Provider Business Mailing Address
First Line	:	5353 REYNOLDS ST
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6015
Country	:	US
Telephone Number	:	912-819-8805
Fax Number	:	912-298-2233

Provider Business Practice Location Address
First Line	:	1055 HOWELL MILL RD NW FL 8
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-5557
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2017
Last Update Date	:	05/18/2026

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