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General NPI Number Information
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NPI Number | 1538685557
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Entity Type | Individual
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Provider Name | AMANDA MICHELLE RODGERS NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/22/2017
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 2021 E ANDREW JOHNSON HWY
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City | MORRISTOWN
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State | TN
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Zip | 37814-5409
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Country | US
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Telephone | 423-587-1406
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Fax | 423-616-0955
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Provider Business Mailing Address
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Address Line | PO BOX 3128
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City | MORRISTOWN
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State | TN
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Zip | 37815-3128
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Country | US
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Telephone | 423-587-1406
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 22889
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License Number State | TN
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