Healthcare Provider Details

I. General information

NPI: 1265554331
Provider Name (Legal Business Name): AMANDA PARRISH REED ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 NW 57TH ST
GAINESVILLE FL
32605-4482
US

IV. Provider business mailing address

1034 NW 57TH ST
GAINESVILLE FL
32605-4482
US

V. Phone/Fax

Practice location:
  • Phone: 352-519-5430
  • Fax: 352-333-6249
Mailing address:
  • Phone: 352-519-5430
  • Fax: 352-333-6249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP9182257
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number9182257
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberARNP9182257
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: