Provider Demographics
NPI:1053614735
Name:LEDBETTER, AMY C (CRNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:LEDBETTER
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 WILLOW COVE RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-5001
Mailing Address - Country:US
Mailing Address - Phone:256-343-1626
Mailing Address - Fax:256-854-2470
Practice Address - Street 1:251 WILLOW COVE RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-5001
Practice Address - Country:US
Practice Address - Phone:256-343-1626
Practice Address - Fax:256-854-2470
Is Sole Proprietor?:No
Enumeration Date:2010-12-17
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-079478363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily