Provider Demographics
NPI:1245726256
Name:YOUNT, AMANDA LYNN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:YOUNT
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 FLAG LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SARAH
Mailing Address - State:MS
Mailing Address - Zip Code:38665-3439
Mailing Address - Country:US
Mailing Address - Phone:901-296-3000
Mailing Address - Fax:
Practice Address - Street 1:364 S FRONT ST STE 201
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-4161
Practice Address - Country:US
Practice Address - Phone:901-296-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902764163WP0808X, 2084P0800X
TN31990163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS902764OtherNURSE PRACTITIONER LICENSE
TN31990OtherNURSE PRACTITIONER LICENSE