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General NPI Number Information
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NPI Number | 1619490372
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Entity Type | Individual
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Provider Name | AMANDA DRAKE MYERS DNP, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/24/2017
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Last Update Date | 05/27/2021
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Provider Practice Location Address
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Address Line | 12610 N COMMUNITY HOUSE RD STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28277-3892
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Country | US
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Telephone | 704-752-3730
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Fax | 704-752-9056
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Provider Business Mailing Address
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Address Line | 205 N MAIN ST
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City | WINGATE
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State | NC
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Zip | 28174-8287
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5009697
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License Number State | NC
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