| NPI | 1770899502 |
|---|---|
| Former Name | AMANDA LAYNE SMALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-096838) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN175222) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2012-11-08 |