Individual
MRS. AMANDA MARKUSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3861 SEPULVEDA BLVD, CULVER CITY, CA 90230-4605
(310) 450-2191
Mailing address
3861 SEPULVEDA BLVD, CULVER CITY, CA 90230-4605
(310) 450-2191
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN9453923
FL
363LF0000X
Family Nurse Practitioner
Primary
95001176
CA
363LF0000X
Family Nurse Practitioner
APRN9453923
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101726100
—
FL
Enumeration date
10/17/2014
Last updated
11/28/2022
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