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General NPI Number Information
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NPI Number | 1427748896
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Entity Type | Individual
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Provider Name | AMANDA L JENNISON APRN
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Gender | Female
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Dates
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Enumeration Date | 05/10/2023
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 13220 BELCHER RD S UNIT 11
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City | LARGO
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State | FL
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Zip | 33773-1678
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Country | US
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Telephone | 727-533-2242
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Fax | 727-533-2252
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Provider Business Mailing Address
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Address Line | 5400 PINEHURST DR
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City | SPRING HILL
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State | FL
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Zip | 34606-3833
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Country | US
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Telephone | 352-277-5305
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Fax | 352-616-0926
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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 | RN9293510
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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 | APRN11026737
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License Number State | FL
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