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General NPI Number Information
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NPI Number | 1518501832
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Entity Type | Individual
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Provider Name | AMANDA BAKER FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/30/2019
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 3901 UNIVERSITY BLVD S STE 221
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4392
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Country | US
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Telephone | 904-423-0010
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Fax | 904-423-0012
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Provider Business Mailing Address
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Address Line | 6936 CYPRESS SPRING CT
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-4818
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Country | US
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Telephone | 904-248-8212
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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 | APRN11004445
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License Number State | FL
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