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Individual

AMANDA WHISNANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
4570 LYONS RD STE 110, COCONUT CREEK, FL 33073-3481
(954) 971-3210
(954) 971-3427
Mailing address
PO BOX 2429, COPPELL, TX 75019-8429
(972) 420-1475
(469) 671-5437

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2674
SC
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN9272409
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100564800
FL
Enumeration date
04/23/2007
Last updated
10/30/2018
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