Provider Demographics
NPI:1962922997
Name:BOONE, AMANDA DAWN (FNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:DAWN
Last Name:BOONE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:DAWN
Other - Last Name:BLACKWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33 GOODEN AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-4143
Mailing Address - Country:US
Mailing Address - Phone:302-678-9355
Mailing Address - Fax:302-678-9310
Practice Address - Street 1:33 GOODEN AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-4143
Practice Address - Country:US
Practice Address - Phone:302-678-9355
Practice Address - Fax:302-678-9310
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0001047363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily