Provider Demographics
NPI:1730575143
Name:MCCORMACK, AMANDA BYRD (ARNP, PMHNP-BC, NP-C)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:BYRD
Last Name:MCCORMACK
Suffix:
Gender:F
Credentials:ARNP, PMHNP-BC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8222 COUNTY ROAD 48
Mailing Address - Street 2:
Mailing Address - City:YALAHA
Mailing Address - State:FL
Mailing Address - Zip Code:34797-3168
Mailing Address - Country:US
Mailing Address - Phone:352-217-4188
Mailing Address - Fax:
Practice Address - Street 1:8222 COUNTY ROAD 48
Practice Address - Street 2:
Practice Address - City:YALAHA
Practice Address - State:FL
Practice Address - Zip Code:34797-3168
Practice Address - Country:US
Practice Address - Phone:352-217-4188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-13
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9164870363LF0000X
FLAPRN91648702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily