Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amanda Daugherty

Individual provider Family Nurse Practitioner · NPI 1780575407

Amanda Daugherty is a Nurse Practitioner in Kennesaw, Georgia. Qualified in 2024, 2 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2025
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Practice location Address checks out

1550 Kennesaw Due West Rd NW
Kennesaw, GA 30152-4338
Phone: (470) 956-7716
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN283355 (GA)

Record details

NPI number1780575407
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorNo
NPI enumeratedJuly 11, 2025
Last updated in NPPESOctober 25, 2025
Certification dateOctober 25, 2025
Mailing address1550 Kennesaw Due West Rd Nw, Kennesaw, GA 30152-4338

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Kennesaw