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General NPI Number Information
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NPI Number | 1538616370
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Entity Type | Individual
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Provider Name | AMANDA LEE HUDNALL PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/09/2016
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 700 TECHNOLOGY DR
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City | SOUTH CHARLESTON
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State | WV
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Zip | 25309-8571
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Country | US
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Telephone | 304-746-5300
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Fax | 304-746-3902
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Provider Business Mailing Address
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Address Line | 1540 SPRING VALLEY DR
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City | HUNTINGTON
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State | WV
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Zip | 25704-9300
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Country | US
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Telephone | 304-429-6741
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Fax | 304-746-3902
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN66786-PMHNP-BC
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License Number State | WV
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