MEDICARE: AMANDA LYNN NOLD PA-C

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	363A00000X	Physician Assistant	1697	AL
2	363A00000X	Physician Assistant	5112	TN

General Provider Information

NPI Number	:	1346845096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA LYNN NOLD PA-C

Provider Business Mailing Address
First Line	:	37 WIND TREE CV
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-2974
Country	:	US
Telephone Number	:	570-903-4683
Fax Number	:

Provider Business Practice Location Address
First Line	:	72 PHYSICIANS DR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-2070
Country	:	US
Telephone Number	:	731-660-6395
Fax Number	:

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

Provider Enumeration Date	:	12/01/2020
Last Update Date	:	02/17/2026

Similar Medicare Providers

1306835483 — DR. LARRY W CARRUTH M.D.
Practice Location Address:

96 PHYSICIANS DR , 96 PHYSICIANS DRIVE
JACKSON, TN
38305-2070

Practice Phone: 731-664-8771
Practice Fax: 731-660-7050

1427026137 — DR. KEITH A MICETICH MD
Practice Location Address:

72 PHYSICIANS DR
JACKSON, TN
38305-2070

Practice Phone: 731-668-4455
Practice Fax: 731-668-9007

1548202500 — LANE E WILLIAMS MD
Practice Location Address:

72 PHYSICIANS DRIVE
JACKSON, TN
38305-2070

Practice Phone: 731-668-4455
Practice Fax: 731-664-4508

1235155276 — JACKSON REGIONAL WOMENS CENTER
Practice Location Address:

72 PHYSICIANS DR
JACKSON, TN
38305-2070

Practice Phone: 731-668-4455
Practice Fax: 731-668-9007

1861409245 — ADAM M SMITH MD
Practice Location Address:

24 PHYSICIANS DR
JACKSON, TN
38305-2070

Practice Phone: 731-661-9825
Practice Fax:

1568470235 — NICOLE S KEARNEY M.D.
Practice Location Address:

60 PHYSICIANS DR
JACKSON, TN
38305-2070

Practice Phone: 731-664-9928
Practice Fax: 731-664-9749

Directions to “ AMANDA LYNN NOLD PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.