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General NPI Number Information
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NPI Number | 1265304489
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Entity Type | Individual
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Provider Name | AMANDA NICOLE COON FNP
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Gender | Female
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 1101 SAM PERRY BLVD STE 400
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4466
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Country | US
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Telephone | 540-741-2865
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Fax |
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Provider Business Mailing Address
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Address Line | 6900 RIDGE WAY DR
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-6276
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Country | US
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Telephone | 804-205-0510
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0024194730
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 0024194730
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License Number State | VA
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