NPI 1144053596

Amanda Puckett Blake, CNM

Practitioner Midwife Austell, GA

Practice location

Address: 1791 Mulkey Rd STE 200, Austell, GA 30106-1124
Phone: (770) 732-5400
Mailing address: 42 Shoals Trl, Dallas, GA 30132-6045

Registered specialties

Midwife Primary

Other Service Providers Taxonomy 176B00000X Licence RN173764 (GA)

Other Midwife providers in Georgia →

Registry record

NPI: 1144053596
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Aug 2024
Record last updated: 21 Aug 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.