Healthcare Provider Details

I. General information

NPI: 1477306488
Provider Name (Legal Business Name): AMANDA ALPER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 N BELAIR RD STE 1C
EVANS GA
30809-3189
US

IV. Provider business mailing address

5086 GRANDE PARK
EVANS GA
30809-4343
US

V. Phone/Fax

Practice location:
  • Phone: 706-854-2160
  • Fax: 706-854-2930
Mailing address:
  • Phone: 586-805-5585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP303213
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: