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General NPI Number Information
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NPI Number | 1336796549
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Entity Type | Individual
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Provider Name | AMANDA COLMAN APRN
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Gender | Female
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 209 HARRISON ST
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City | TITUSVILLE
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State | FL
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Zip | 32780-5027
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Country | US
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Telephone | 321-380-3211
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Fax |
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Provider Business Mailing Address
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Address Line | 209 HARRISON ST
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City | TITUSVILLE
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State | FL
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Zip | 32780-5027
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Country | US
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Telephone | 321-380-3211
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN11003545
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License Number State | FL
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