Provider Demographics
NPI:1730579889
Name:ADCOCK, AMANDA KAYE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:KAYE
Last Name:ADCOCK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2239
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35609-2239
Mailing Address - Country:US
Mailing Address - Phone:256-973-2738
Mailing Address - Fax:256-973-4805
Practice Address - Street 1:1215 7TH ST SE STE 240
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3397
Practice Address - Country:US
Practice Address - Phone:256-973-4885
Practice Address - Fax:256-973-4805
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-105229363L00000X
AL1052292084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner