| Doctor Name: | AMANDA MCDONALD |
| NPI Number: | 1851798755 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN, NP-C |
| License Number: | 3008822 |
| Business Practice Address: | 2465 Lakeway Dr Russell Springs, KY - 426424510 |
| Business Phone Number: | 2708583636 |
| Business Fax Number: | 2708583660 |
| Mailing Address: | 2465 Lakeway Dr, RUSSELL SPRINGS |
| State: | KY |
| Postal Code: | 426424510 |
| Phone Number: | 2708583636 |
| Fax Number: | 2708583660 |
| NPI Enumeration Date: | 11/21/2014 |
| NPI Last Update Date: | 02/24/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 3008822 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |