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Individual

AMANDA KERI LUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, APRN, PMHNP

Contact information

Practice address
6580 72ND AVE N STE A, PINELLAS PARK, FL 33781-4047
(727) 440-5612
(727) 388-3767
Mailing address
PO BOX 10970, SAINT PETERSBURG, FL 33733-0970

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11033844
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
125498200
FL
Enumeration date
08/08/2024
Last updated
06/24/2025
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