| Amanda Daugherty, | |
|
1550 Kennesaw Due West Rd Nw, Kennesaw, GA 30152-4338 | |
| (470) 956-7716 | |
| Not Available |
| Full Name | Amanda Daugherty |
|---|---|
| Gender | |
| Speciality | Nurse Practitioner |
| Experience | 2 Years |
| Location | 1550 Kennesaw Due West Rd Nw, Kennesaw, Georgia |
| Accepts Medicare Assignments | Yes. This provider accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780575407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | RN283355 (Georgia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wellstar Medical Group Llc | 6709065402 | 3059 |
| Entity Name | Wellstar Medical Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Daugherty, 1550 Kennesaw Due West Rd Nw, Kennesaw, GA 30152-4338 Ph: Not Available | Amanda Daugherty, 1550 Kennesaw Due West Rd Nw, Kennesaw, GA 30152-4338 Ph: (470) 956-7716 |
Lisa Vivienne Poling, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1000 Chastain Rd Nw, Kennesaw, GA 30144 Phone: 678-797-2844 Fax: 678-797-2827 |
Ms. Tanya S Wilcox, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1770 Dennis Kemp Ln Nw, Kennesaw, GA 30152 Phone: 770-515-9000 |
Khadijah Fife Phillips, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Po Box 441065, Kennesaw, GA 30160 Phone: 516-782-8988 |
Mrs. Martricia Meshonna Turner, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3805 Cherokee St Nw, Kennesaw, GA 30144 Phone: 770-426-5666 Fax: 770-426-6205 |
Ms. Stacey Levison, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2782 Cobb Pkwy Nw, Kennesaw, GA 30152 Phone: 770-590-8181 |
Shakira Lynn, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2782 N Cobb Pkwy, Kennesaw, GA 30152 Phone: 877-993-4321 |
Ms. Kimberly Noel Johnson, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1180 Ernest W Barrett Pkwy Nw # 102b, Kennesaw, GA 30144 Phone: 678-354-2273 |