Provider Demographics
NPI:1932097029
Name:MING, AMANDA M (RDN)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:M
Last Name:MING
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 ROCKBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-5027
Mailing Address - Country:US
Mailing Address - Phone:769-257-1830
Mailing Address - Fax:769-257-1830
Practice Address - Street 1:113 ROCKBRIDGE CIR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-5027
Practice Address - Country:US
Practice Address - Phone:769-257-1830
Practice Address - Fax:769-257-1830
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD1843133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered