Provider Demographics
NPI:1720623275
Name:MCCARTHY, AMAYA JOHNSON (ARNP)
Entity type:Individual
Prefix:
First Name:AMAYA
Middle Name:JOHNSON
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AMAYA
Other - Middle Name:JOHNSON
Other - Last Name:MCCARTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:130 N 18TH ST
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-2651
Mailing Address - Country:US
Mailing Address - Phone:912-467-2640
Mailing Address - Fax:
Practice Address - Street 1:22455 FLORA PARKE XING
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-8000
Practice Address - Country:US
Practice Address - Phone:904-572-1884
Practice Address - Fax:904-491-1118
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9317044163WE0003X
FLAPRN11006158363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency