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General NPI Number Information
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NPI Number | 1659282473
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Entity Type | Organization
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Legal Business Name | AMENITY HEALTHCARE
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Dates
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Enumeration Date | 09/14/2026
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Last Update Date | 09/14/2026
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Provider Practice Location Address
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Address Line | 30 E BROADWAY STE 2031149
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City | SALT LAKE CITY
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State | UT
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Zip | 84111-2227
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Country | US
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Telephone | 813-773-1932
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Fax | 813-537-8735
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N # 18547
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4305
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Country | US
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Telephone | 813-773-1932
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Fax | 813-537-8735
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. CHRISTINA C BRADDY
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Credential | FNP-C, PMHNP-BC
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Telephone | 813-773-1932
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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