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General NPI Number Information
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NPI Number | 1326534504
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Entity Type | Individual
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Provider Name | AMANDA MARTEN NP
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Gender | Female
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Dates
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Enumeration Date | 07/10/2018
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 5230 DALLAS HWY
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-4263
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Country | US
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Telephone | 404-948-3019
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Fax |
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Provider Business Mailing Address
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Address Line | 2007 PALM BEACH LAKES BLVD
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-6501
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Country | US
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Telephone | 561-420-8555
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Fax | 561-420-8550
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | GA240150
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 812293
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11007132
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 240150
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License Number State | GA
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