Provider Demographics
NPI:1538904016
Name:HOWARD, AMANDA CHRISTINE (PMHNP-BC, RN, CRNP)
Entity type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:CHRISTINE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PMHNP-BC, RN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 QUAIL RUN S
Mailing Address - Street 2:
Mailing Address - City:THEODORE
Mailing Address - State:AL
Mailing Address - Zip Code:36582-8805
Mailing Address - Country:US
Mailing Address - Phone:251-454-8559
Mailing Address - Fax:
Practice Address - Street 1:3929 AIRPORT BLVD STE 2-204
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-2241
Practice Address - Country:US
Practice Address - Phone:251-480-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-188141163W00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse