Provider Demographics
NPI:1588054621
Name:REES, AMANDA JAYNE (ARNP; FNP-C)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JAYNE
Last Name:REES
Suffix:
Gender:F
Credentials:ARNP; FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 GASPARILLA PINES BLVD
Mailing Address - Street 2:UNIT 207
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34224-9723
Mailing Address - Country:US
Mailing Address - Phone:941-697-7640
Mailing Address - Fax:
Practice Address - Street 1:6600 GASPARILLA PINES BLVD
Practice Address - Street 2:UNIT 207
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34224-9723
Practice Address - Country:US
Practice Address - Phone:941-697-7640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA473379163W00000X
FL9267706163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163W00000XNursing Service ProvidersRegistered Nurse