Healthcare Provider Details

I. General information

NPI: 1205999844
Provider Name (Legal Business Name): AMANDA J EDWARDS AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 03/16/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 21ST AVE S SUITE 9302
NASHVILLE TN
37232-8025
US

IV. Provider business mailing address

3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE TN
37215-2691
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-4327
  • Fax: 615-936-5088
Mailing address:
  • Phone: 615-936-2000
  • Fax: 615-936-5088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY1681
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1395
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: