MEDICARE: AMANDA LAHMAN FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11027261	FL

General Provider Information

NPI Number	:	1073375408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA LAHMAN FNP

Provider Business Mailing Address
First Line	:	1500 1ST AVE N UNIT 3
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35203-1866
Country	:	US
Telephone Number	:	205-545-5088
Fax Number	:

Provider Business Practice Location Address
First Line	:	14044 SE 48TH AVE
Second Line	:
City	:	STARKE
State	:	FL
Zip	:	32091-6849
Country	:	US
Telephone Number	:	904-263-5422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2024
Last Update Date	:	01/30/2024

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