Provider Demographics
NPI:1699345751
Name:PRINCE, AMY ELIZABETH (APRN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:PRINCE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6230 RIVERWALK LN UNIT 2
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7902
Mailing Address - Country:US
Mailing Address - Phone:561-253-5067
Mailing Address - Fax:
Practice Address - Street 1:5305 GREENWOOD AVE STE 204
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2449
Practice Address - Country:US
Practice Address - Phone:561-882-6060
Practice Address - Fax:561-845-2297
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2022-05-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013959363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner