AMANDA NICOLE CLEGHORNE (NPI# 1104277474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104277474 |
| Entity Type | Individual |
| Full Name | AMANDA NICOLE CLEGHORNE |
| Credential | NP-C |
| Practice Address |
4355 Browns Bridge Rd Suite 1 Cumming GA 30041-4554 |
| Mailing Address |
4355 Browns Bridge Rd Cumming GA 30041-4554 |
| Practice Telephone | 7707715050 |
| Practice Fax Number | 7707715051 |
| Mailing Telephone | 7707715050 |
| Mailing Fax Number | 7707715051 |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2016-06-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
RN 218110 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | APRN | RN 218110 | 01 |
| Street Address |
4355 BROWNS BRIDGE RD SUITE 1 |
| City | CUMMING |
| State | GA |
| Zip Code | 30041-4554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639568066 | Erika Kang | Nurse Practitioner | 4355 Browns Bridge Rd, Cumming, GA 30041-4554 | 2015-01-22 |
| 1245768266 | Heather Hawn Fry | Nurse Practitioner | 4355 Browns Bridge Rd, Cumming, GA 30041-4554 | 2017-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962036905 | Annie Kyungjin Han | Nurse Practitioner | 1505 Northside Forsyth Drive, Suite 2500, Cumming, GA 30041 | 2020-02-28 |
| 1295388197 | Pamela Edler | Pharmacist | 1200 Northside Forsyth Drive, Pharmacy Department, Cumming, GA 30041 | 2019-07-19 |
| 1720557127 | Dr. Tiffany Lamonde LLC | Physical Therapist | 1445 Haw Creek Circle, Suite 503, Cumming, GA 30041 | 2018-11-15 |
| 1487140893 | Bhbd LLC | Chiropractor | 425 Peachtree Parkway, Suite 315, Cumming, GA 30041 | 2018-07-09 |
| 1891219861 | Anna Gawrys | Pharmacist | 1525 Marketplace Blvd, Cumming, GA 30041 | 2017-08-01 |
| 1679029219 | Square One Dental LLC | Clinic/Center | 3510 Rowe Lane, Cumming, GA 30041 | 2016-09-01 |
| 1720441454 | Pavilion Psychological Services LLC | Psychologist | 1445 Haw Creek Corners Circle East, Suite 501, Cumming, GA 30041 | 2016-03-31 |
| 1346606506 | American Health Imaging of Ga, LLC | Clinic/Center | 1050 Haw Creek Pkwy, Suite 100, Cumming, GA 30041 | 2016-01-04 |
| 1013311307 | Stephen Hartle | Physician Assistant | 2576 Peachtree Pkwy, Suite 100, Cumming, GA 30041 | 2014-10-15 |
| 1063828408 | Stephanie Evans Wellborn | Physician Assistant | 1800 Northside Forsyth Dr Ste 450, Cumming, GA 30041 | 2014-07-07 |
| Find all providers in zip 30041 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043844996 | Amcare Visiting Physician Services LLC | Nurse Practitioner | 2930 Grangehill Way, Cumming, GA 30041-6200 | 2020-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639784788 | Natasha Allen | Nurse Practitioner | 4177 Pelham Cir, Lithonia, GA 30038-6140 | 2020-09-14 |
| 1336753920 | Henny P Brown | Nurse Practitioner | 3430 Ridgeland Pl, Alpharetta, GA 30004-8483 | 2020-09-01 |
| 1487267415 | Alethea Hope Tucker | Nurse Practitioner | 3685 Braselton Hwy Ste 100, Dacula, GA 30019-5920 | 2020-08-28 |
| 1952913808 | Carol Jo Wilbanks | Nurse Practitioner | 206 Crest Dr, Rock Spring, GA 30739-2041 | 2020-08-21 |
| 1164032017 | Myiesha Sellers Mcfarlin | Nurse Practitioner | 55 Sellers Ln, Baxley, GA 31513-2208 | 2020-08-05 |
| 1124645395 | Kisha Smalley | Nurse Practitioner | 117 Gambier Cv, Mcdonough, GA 30252-6273 | 2020-07-02 |
| 1346861127 | Finan Tedla | Nurse Practitioner | 2626 Peachtree Rd Nw Unit 1802, Atlanta, GA 30305-5633 | 2020-05-03 |
| 1841819547 | Millicent Charte Duncan | Nurse Practitioner | 138 Parkview Rd, Savannah, GA 31419-9672 | 2020-04-13 |
| 1891329660 | Tracey Lynn Murray | Nurse Practitioner | 980 Johnson Ferry Rd Ste 880, Sandy Springs, GA 30342-1609 | 2020-03-02 |
| 1841820917 | Vedic Family Practice and Wellness | Nurse Practitioner | 1240 Upper Hembree Rd Ste E, Roswell, GA 30076-0914 | 2020-01-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.