Provider Demographics
NPI:1265303531
Name:MORAN, AMY JEAN (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:JEAN
Last Name:MORAN
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 LATTICE DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-7969
Mailing Address - Country:US
Mailing Address - Phone:407-341-9835
Mailing Address - Fax:
Practice Address - Street 1:81 LATTICE DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-7969
Practice Address - Country:US
Practice Address - Phone:407-341-9835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN110423132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry