Provider Demographics
NPI:1104007376
Name:ADKINS, AMANDA FAYE (ARNP-C)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:FAYE
Last Name:ADKINS
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 DUNLAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-9226
Mailing Address - Country:US
Mailing Address - Phone:888-808-0488
Mailing Address - Fax:386-872-4232
Practice Address - Street 1:735 DUNLAWTON AVE
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-9226
Practice Address - Country:US
Practice Address - Phone:888-808-0488
Practice Address - Fax:386-872-4232
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9194440363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL363L00000XOtherTAXONOMY