Individual
MISS AMANDA NICOLE CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
601 5TH ST S, 306, ST PETERSBURG, FL 33701-4804
(727) 767-3779
(727) 767-4346
Mailing address
601 5TH ST S, 306, ST PETERSBURG, FL 33701-4804
(727) 767-3779
(727) 767-4346
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9106489
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11111
NONE
—
Enumeration date
04/25/2012
Last updated
04/25/2012
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