Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 5014855 | NC |
NPI | 1033882691 |
---|---|
Provider Name | Amanda Joy Bentley |
First Address | Fletcher, NC 28732-4504 |
Second Address | Hendersonville, NC 28792-5272 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2021 |
Last Update Date | 10/08/2021 |