Provider Demographics
NPI:1760750566
Name:HARP, AMY E (APRN/FNP-C)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:E
Last Name:HARP
Suffix:
Gender:F
Credentials:APRN/FNP-C
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ELIZABETH
Other - Last Name:HARP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:3563 PHILIPS HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-5627
Mailing Address - Country:US
Mailing Address - Phone:904-202-4600
Mailing Address - Fax:904-376-4107
Practice Address - Street 1:3563 PHILIPS HWY STE 201
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-5627
Practice Address - Country:US
Practice Address - Phone:904-202-4600
Practice Address - Fax:904-202-4639
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9397713363LF0000X
FLAPRN9397713363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MH2629941OtherDEA