MEDICARE: AMANDA CARPENTER NEAL MHS, PA-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	363A00000X	Physician Assistant	0010-01059	NC

General Provider Information

NPI Number	:	1669660312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA CARPENTER NEAL MHS, PA-C

Provider Business Mailing Address
First Line	:	10012 BAILEYWICK RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27613-6202
Country	:	US
Telephone Number	:	919-302-1742
Fax Number	:

Provider Business Practice Location Address
First Line	:	7021 HARPS MILL RD
Second Line	:	SUITE 100
City	:	RALEIGH
State	:	NC
Zip	:	27615-3240
Country	:	US
Telephone Number	:	919-845-2125
Fax Number	:

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

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	07/05/2025

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