| Doctor Name: | MRS. AMANDA MCNULTY |
| NPI Number: | 1851710685 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RN218786 |
| Business Practice Address: | 308 Bedell Ave Woodbine, GA - 315692091 |
| Business Phone Number: | 9125765999 |
| Business Fax Number: | 9125765888 |
| Mailing Address: | 107 Cypress Bnd, KINGSLAND |
| State: | GA |
| Postal Code: | 315485642 |
| Phone Number: | 9045574306 |
| Fax Number: | 9125765888 |
| NPI Enumeration Date: | 04/09/2014 |
| NPI Last Update Date: | 07/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN218786 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |