MEDICARE: AMANDA J EDWARDS AUD

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	231H00000X	Audiologist	AY1681	FL
2	231H00000X	Audiologist	1395	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	613258400	OTHER		OWCP-DOL FECA AND DEEOIC
2	9068084	OTHER	TN	AETNA
3	4165989	OTHER	TN	BCBS OF TN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	01161027	OTHER	TN	AMERIGROUP TENNCARE
6	10028887	OTHER		SIGNATURE HEALTH PLANS
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	5687960	OTHER		CIGNA

General Provider Information

NPI Number	:	1205999844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA J EDWARDS AUD

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:	615-936-2000
Fax Number	:	615-936-5088

Provider Business Practice Location Address
First Line	:	1215 21ST AVE S
Second Line	:	SUITE 9302
City	:	NASHVILLE
State	:	TN
Zip	:	37232-8025
Country	:	US
Telephone Number	:	615-322-4327
Fax Number	:	615-936-5088

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	03/16/2022

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