Individual
AMANDA S. PUMILIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1641 TAMIAMI TRL, PORT CHARLOTTE, FL 33948-1018
(419) 629-6262
(941) 629-1782
Mailing address
BOX 78534, MILWAUKEE, WI 53278
(815) 398-9491
(815) 381-7498
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-348345
IL
363L00000X
Nurse Practitioner
Primary
209-014962
IL
Other
Enumeration date
09/14/2016
Last updated
04/15/2021
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