MEDICARE: AMANDA BLAIR THORNTON APRN

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	363LF0000X	Family Nurse Practitioner	26519	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306486519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA BLAIR THORNTON APRN

Provider Business Mailing Address
First Line	:	2504 REGENTS WALK
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-5809
Country	:	US
Telephone Number	:	901-826-2888
Fax Number	:

Provider Business Practice Location Address
First Line	:	2504 REGENTS WALK
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-5809
Country	:	US
Telephone Number	:	901-826-2888
Fax Number	:

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

Provider Enumeration Date	:	01/15/2020
Last Update Date	:	05/18/2026

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