| NPI | 1184687600 |
|---|---|
| Former Name | AMY LYNN PHELPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN PA1430) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA 20431) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2015-12-23 |