AMANDA BOSTOCK SOWISDRAL (NPI# 1083133912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083133912 |
| Entity Type | Individual |
| Full Name | AMANDA BOSTOCK SOWISDRAL |
| Credential | PA-C |
| Practice Address |
250 Parkbrooke Pl Ste 300 Woodstock GA 30189 |
| Mailing Address |
Po Box 1093 Woodstock GA 30188-1093 |
| Practice Telephone | 7704421911 |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2019-01-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
250 PARKBROOKE PL STE 300 |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494356 | Susan Iruku | Pharmacist | 12050 Ga-92 #112, Woodstock, GA 30189 | 2020-10-15 |
| 1598267437 | Kelly Sierra | Nurse Practitioner | 100 Stoneforest Dr Ste 300, Woodstock, GA 30189 | 2018-03-07 |
| 1548770449 | Chandra Johnson | Nurse Practitioner | 295 Molly Lane Ste 150, Woodstock, GA 30189 | 2017-10-05 |
| 1780101659 | Laura C Koch Woodstock LLC Dba Fountain View Dentistry | Dentist | 1816 Eagle Drive, Building 200-a, Woodstock, GA 30189 | 2017-08-23 |
| 1265954788 | Vicky Morton Bryan | Nurse Practitioner | 422 Sycamore Trail, Woodstock, GA 30189 | 2017-07-17 |
| 1063933588 | Marietta Eye Clinic, Pa | Optometrist | 2990 Eagle Dr Ste 110, Woodstock, GA 30189 | 2017-07-06 |
| 1275914749 | Nrup Tolat | Podiatrist | 100 Stoneforest Dr Ste 120, Woodstock, GA 30189 | 2015-06-10 |
| 1558781534 | Mary Jansson Carmon | Nurse Practitioner | 1000 Towne Lake Pkwy, Woodstock, GA 30189 | 2014-04-17 |
| 1518388941 | Afc Physicians of Georgia, PC | General Practice | 6440 Bells Ferry Rd, Woodstock, GA 30189 | 2014-01-03 |
| 1659702884 | Dana Dunlap | Physician Assistant | 8814 Hwy 9, 114, Woodstock, GA 30189 | 2013-12-13 |
| Find all providers in zip 30189 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245838804 | Erin Washington | Physician Assistant | 2708 Tallowtree Rd, Woodstock, MD 21163-1462 | 2020-10-15 |
| 1215476098 | Carina C Cardillo | Physician Assistant | 7559 South Main Street, Suite 310, Woodstock, VA 22664 | 2017-02-14 |
| 1659702884 | Dana Dunlap | Physician Assistant | 8814 Hwy 9, 114, Woodstock, GA 30189 | 2013-12-13 |
| 1235432170 | Deidra Dyan Munsanto | Physician Assistant | 12201 Highway 92 Ste D, Woodstock, GA 30188 | 2010-12-15 |
| 1306910187 | Denise Arlen Mcnatt | Physician Assistant | 10413 Saddlebred Trl, Woodstock, IL 60098-8672 | 2006-11-20 |
| 1689633414 | Bruce Alan Cavanaugh | Physician Assistant | 9987 Village Green Dr, Woodstock, MD 21163-1155 | 2006-03-21 |
| 1962484154 | Laura B Vahey | Physician Assistant | 32 Pleasant Street, Woodstock, VT 05091 | 2005-11-15 |
| 1356837348 | Jamie Ailed Quinones-borges | Physician Assistant | 7820 Hickory Flat Hwy, Woodstock, GA 30188-2099 | 2018-07-02 |
| 1841788734 | Christian Smith Galloway | Physician Assistant | 960 Woodstock Pkwy Ste 200, Woodstock, GA 30188-4867 | 2018-04-25 |
| 1114476553 | Alexandra Clifton | Physician Assistant | 28921 Highway 5, Woodstock, AL 35188-3613 | 2016-09-27 |
| Find all providers in WOODSTOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.