Provider Demographics
NPI:1801476270
Name:DULANEY, AMANDA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:DULANEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:DULANEY
Other - Last Name:BYRD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7514 CORPORATE CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3877
Mailing Address - Country:US
Mailing Address - Phone:662-541-0550
Mailing Address - Fax:
Practice Address - Street 1:7514 CORPORATE CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3877
Practice Address - Country:US
Practice Address - Phone:901-757-5333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-10
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29135363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner