Basic Information
| Provider Information | |||||||||
| NPI: | 1255675930 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWNING | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | JANE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 PARK ST | ||||||||
| Address2: | |||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421011759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2705241201 | ||||||||
| FaxNumber: | 2705241202 | ||||||||
| Practice Location | |||||||||
| Address1: | 950 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MUNFORDVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 427659435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2705241201 | ||||||||
| FaxNumber: | 2705241202 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2012 | ||||||||
| LastUpdateDate: | 02/03/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 3007614 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 7100230020 | 05 | KY | MEDICAID |