Individual
AMANDA YUN ANANIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3535 PENTAGON BLVD STE 330, BEAVERCREEK, OH 45431-1705
(937) 757-9449
(937) 702-4944
Mailing address
1380 E STROOP RD, KETTERING, OH 45429-4926
(937) 294-4356
(937) 297-2381
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9106438
FL
363A00000X
Physician Assistant
—
FL
363AM0700X
Medical Physician Assistant
Primary
50.005533RX
OH
363AM0700X
Medical Physician Assistant
PA9106438
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005470100
—
FL
05
—
0306837
—
OH
01
—
PA9106438
MEDICAL LICENSE
FL
Enumeration date
01/21/2012
Last updated
11/18/2020
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