| Doctor Name: | MRS. AMANDA ROSE DAUGHERTY |
| NPI Number: | 1215193644 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | NP10110 |
| Business Practice Address: | 6417 Columbus Pike Lewis Center, OH - 43035 |
| Business Phone Number: | 7402016515 |
| Business Fax Number: | 6143280342 |
| Mailing Address: | 8 Cadillac Dr, Suite 250 BRENTWOOD |
| State: | TN |
| Postal Code: | 370275087 |
| Phone Number: | 6154254200 |
| Fax Number: | 6154254271 |
| NPI Enumeration Date: | 08/05/2008 |
| NPI Last Update Date: | 04/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP10110 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |