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General NPI Number Information
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NPI Number | 1427159128
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Entity Type | Individual
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Provider Name | AMY CHRISTINE FEDERICO NP
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 84 PINNACLES DR STE 400
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City | PALM COAST
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State | FL
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Zip | 32164-2324
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Country | US
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Telephone | 386-256-1969
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Fax |
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Provider Business Mailing Address
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Address Line | 84 PINNACLES DR STE 400
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City | PALM COAST
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State | FL
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Zip | 32164-2324
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Country | US
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Telephone | 386-256-1969
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11018415
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 230163
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License Number State | MA
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