Healthcare Provider Details

I. General information

NPI: 1649347048
Provider Name (Legal Business Name): AMANDA MICHELLE CLINE-GRANT DC, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 98
GRANTSBORO NC
28529-0098
US

IV. Provider business mailing address

PO BOX 98
GRANTSBORO NC
28529-0098
US

V. Phone/Fax

Practice location:
  • Phone: 252-999-3799
  • Fax: 252-805-8748
Mailing address:
  • Phone: 252-999-3799
  • Fax: 252-805-8748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5021076
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3167
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: