Individual
AMANDA WILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1213 STATE ROAD 20, INTERLACHEN, FL 32148-2737
(904) 698-9098
Mailing address
1302 RIVER ST, PALATKA, FL 32177-5042
(386) 328-0108
(386) 325-1086
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11029179
FL
Other
Enumeration date
10/16/2023
Last updated
04/03/2024
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