Individual
AMANDA B PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
9349014
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01118046
RAILROAD MEDICARE
FL
01
—
Y0E3S
BCBS-FL
FL
Enumeration date
08/30/2012
Last updated
02/11/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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