Healthcare Provider Details

I. General information

NPI: 1962348227
Provider Name (Legal Business Name): AMANDA SCHURWANZ RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA TAYLOR RN

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 CAMDEN PT
MADISON MS
39110-4018
US

IV. Provider business mailing address

129 CAMDEN PT
MADISON MS
39110-4018
US

V. Phone/Fax

Practice location:
  • Phone: 602-377-6356
  • Fax:
Mailing address:
  • Phone: 602-377-6356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number930644
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-319864
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: