MEDICARE: MRS. AMANDA JAYNE ATCHISON PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11037751	FL

General Provider Information

NPI Number	:	1881499184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA JAYNE ATCHISON PMHNP-BC

Provider Business Mailing Address
First Line	:	1111 NE 25TH AVE STE 201
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34470-5666
Country	:	US
Telephone Number	:	877-779-2429
Fax Number	:	352-619-8216

Provider Business Practice Location Address
First Line	:	1111 NE 25TH AVE STE 201
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34470-5666
Country	:	US
Telephone Number	:	352-234-3078
Fax Number	:	352-619-8216

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2025
Last Update Date	:	03/05/2026

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