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

Amanda Mathews Vicznesky, PA

Individual provider Physician Assistant · NPI 1174177752

Amanda Mathews Vicznesky, PA is a Physician Assistant in Austell, Georgia. Works from 2 locations. Licensed in Georgia.

Licensed in
GA
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3950 Austell Rd
Austell, GA 30106-1121
Phone: (470) 732-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 450 Northside Cherokee Blvd, Canton, GA 30115-8015 — (770) 224-1000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9456 (GA)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1174177752
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 31, 2019
Last updated in NPPESAugust 7, 2023
Certification dateAugust 7, 2023

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