NPI age
14 years
Enumerated 2011-09-13
● Active
Type 1 · Individual
Amanda Daniel Wallace, PA-C
Wallace is 1 of 55 physician assistant providers in Gainesville and 1 of 640 in Georgia.
Primary specialty
Physician Assistant
Plus 2 subspecialties
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2023-09-26
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 640 active physician assistant providers in Georgia.
NPI age
14 years
≈ at median (13 yr)
State licenses
1 state
10% of peers hold multiple states
Subspecialties
2
In the 37% of peers with subspecialties
NPI lifetime · 2011 → 2026
2011-09Enumerated in NPPES
2011
2026
Where they practice
Practice location
655 Jesse Jewell Pkwy Se Ste B
Gainesville, GA 305013854
Mailing address
Po Box 658
Gainesville, GA 305030658
Additional practice locations
8 secondary locations on file with NPPES.
Location 2
1270 Friendship Rd
Braselton, GA 305175630
Location 3
1945 Beverly Rd
Gainesville, GA 305012034
Location 4
725 Jesse Jewell Pkwy Se
Gainesville, GA 305013834
Location 5
743 Spring St Ne
Gainesville, GA 305013715
Location 6
1400 River Pl
Braselton, GA 305175600
Location 7
1765 Old West Broad St
Athens, GA 306062853
Location 8
835 Austin Dr
Demorest, GA 305354513
Location 9
801 Austin Dr
Demorest, GA 305354513
Specialties
-
Physician Assistant PrimaryDefinition to come...
-
Physician AssistantA 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...
-
Physician AssistantDefinition to come...
Practice context
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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