Provider Demographics
NPI:1609619444
Name:FREEDMAN, AMANDA FAYE (MSN, APRN, RN, ACNS-)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:FAYE
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:MSN, APRN, RN, ACNS-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 PREACHER HOLMES RD
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-9111
Mailing Address - Country:US
Mailing Address - Phone:336-675-2787
Mailing Address - Fax:
Practice Address - Street 1:3000 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1231
Practice Address - Country:US
Practice Address - Phone:919-350-8895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC153582364SA2200X, 364SP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP1700XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerinatalGroup - Multi-Specialty
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health