MEDICARE: AMANDA L PERKINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	31486	SC
2	363L00000X	Nurse Practitioner	1-181546	AL
3	363L00000X	Nurse Practitioner	908141	MS

General Provider Information

NPI Number	:	1164230736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA L PERKINS

Provider Business Mailing Address
First Line	:	148 J C MAULDIN HWY
Second Line	:
City	:	KILLEN
State	:	AL
Zip	:	35645-9106
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 PERIMETER PARK S STE 195A
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-2327
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2024
Last Update Date	:	02/02/2026

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Directions to “ AMANDA L PERKINS ” Practice Location

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