MEDICARE: MS. AMANDA BROOKE TURNER APN

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	24656	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	:	1932681178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMANDA BROOKE TURNER APN

Provider Business Mailing Address
First Line	:	3771 W SHAWTOWN RD
Second Line	:
City	:	TROY
State	:	TN
Zip	:	38260-4047
Country	:	US
Telephone Number	:	731-796-0194
Fax Number	:

Provider Business Practice Location Address
First Line	:	1109 E REELFOOT AVE STE D
Second Line	:
City	:	UNION CITY
State	:	TN
Zip	:	38261-5866
Country	:	US
Telephone Number	:	731-599-9909
Fax Number	:	731-599-9970

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

Provider Enumeration Date	:	09/04/2018
Last Update Date	:	12/05/2022

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