Basic Information
Provider Information
NPI: 1538706841
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGEE
FirstName: AMANDA
MiddleName: ONEY
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7200
Address2:  
City: ROCKY MOUNT
State: NC
PostalCode: 278040200
CountryCode: US
TelephoneNumber: 2529370351
FaxNumber: 2524510056
Practice Location
Address1: 901 N WINSTEAD AVE
Address2:  
City: ROCKY MOUNT
State: NC
PostalCode: 278048467
CountryCode: US
TelephoneNumber: 2529370290
FaxNumber: 2529373111
Other Information
ProviderEnumerationDate: 12/05/2019
LastUpdateDate: 12/05/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LG0600X253353NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology

ID Information
IDTypeStateIssuerDescription
25335301NCNP LICENSEOTHER


Home