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General NPI Number Information
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NPI Number | 1962545731
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Entity Type | Individual
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Provider Name | IRIS D AMAKER RN,MSN,WHNP, NP-C,
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Gender | Female
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 2670 COBB PKWY SE
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City | SMYRNA
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State | GA
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Zip | 30080-3014
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Country | US
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Telephone | 678-813-4638
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Fax | 770-955-8787
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Provider Business Mailing Address
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Address Line | 2670 COBB PKWY SE
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City | SMYRNA
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State | GA
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Zip | 30080-3014
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Country | US
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Telephone | 404-488-3482
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Fax | 678-813-4538
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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 | NP041284
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | NP041284
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License Number State | GA
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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 | FO804127
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License Number State | GA
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