Provider Demographics
NPI:1780928523
Name:DONALDSON, AMANDA (APN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GREAT CIRCLE RD
Mailing Address - Street 2:STE. 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1317
Mailing Address - Country:US
Mailing Address - Phone:615-284-2988
Mailing Address - Fax:615-284-2995
Practice Address - Street 1:2010 CHURCH ST
Practice Address - Street 2:STE. 201
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2012
Practice Address - Country:US
Practice Address - Phone:615-284-2988
Practice Address - Fax:615-284-2995
Is Sole Proprietor?:No
Enumeration Date:2012-11-17
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000016906363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNPENDINGOtherRR MEDICARE
TNQ014566Medicaid
TN6043465OtherBCBST
TN6043465OtherBCBST