Individual
AMANDA LEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9454 THREE RIVERS RD, SUITE A, GULFPORT, MS 39503-4294
(228) 864-7747
(228) 864-7415
Mailing address
9454 THREE RIVERS RD, SUITE A, GULFPORT, MS 39503-4294
(228) 864-7747
(228) 864-7415
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R863406
MS
Other
Enumeration date
06/04/2014
Last updated
06/04/2014
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