Provider Demographics
NPI:1033904065
Name:CONNERTON, AMANDA (APRN-CNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:CONNERTON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11701 LAKE VICTORIA GARDENS AVE STE 3108
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2705
Mailing Address - Country:US
Mailing Address - Phone:203-278-0473
Mailing Address - Fax:
Practice Address - Street 1:11701 LAKE VICTORIA GARDENS AVE STE 3108
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2705
Practice Address - Country:US
Practice Address - Phone:203-278-0473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11039007363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner