| Doctor Name: | AMANDA LYNN MAYNARD |
| NPI Number: | 1114279635 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | 63087 |
| Business Practice Address: | 428 E Main St Inez, KY - 412248931 |
| Business Phone Number: | 6062982660 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1269, INEZ |
| State: | KY |
| Postal Code: | 412241269 |
| Phone Number: | 6065347500 |
| Fax Number: | |
| NPI Enumeration Date: | 10/08/2012 |
| NPI Last Update Date: | 10/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 63087 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |