Basic Information
| Provider Information | |||||||||
| NPI: | 1205999844 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EDWARDS | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3841 GREEN HILLS VILLAGE DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372152691 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159362000 | ||||||||
| FaxNumber: | 6159365088 | ||||||||
| Practice Location | |||||||||
| Address1: | 1215 21ST AVE S | ||||||||
| Address2: | SUITE 9302 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372328025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153224327 | ||||||||
| FaxNumber: | 6159365088 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2006 | ||||||||
| LastUpdateDate: | 03/16/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AY1681 | FL | N | Speech, Language and Hearing Service Providers | Audiologist | 231H00000X | 1395 | TN | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 613258400 | 01 | OWCP-DOL FECA AND DEEOIC | OTHER | 9068084 | 01 | TN | AETNA | OTHER | 4165989 | 01 | TN | BCBS OF TN | OTHER | 7100033990 | 05 | KY | MEDICAID | 01161027 | 01 | TN | AMERIGROUP TENNCARE | OTHER | 10028887 | 01 | SIGNATURE HEALTH PLANS | OTHER | 39671221 | 05 | TN | MEDICAID | 5687960 | 01 | CIGNA | OTHER |