Healthcare Provider Details

I. General information

NPI: 1316605959
Provider Name (Legal Business Name): AMANDA DAWN PETERS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 ONEAL ST STE 5
GAINESVILLE TX
76240-3610
US

IV. Provider business mailing address

1512 TEASLEY LN
DENTON TX
76205-7282
US

V. Phone/Fax

Practice location:
  • Phone: 940-580-3070
  • Fax:
Mailing address:
  • Phone: 940-442-5209
  • Fax: 940-222-2720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1059846
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: