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Individual

AMANDA KELLY WNEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
6716 NW 11TH PL STE 200, GAINESVILLE, FL 32605-4201
(352) 331-9729
Mailing address
PO BOX 100279, GAINESVILLE, FL 32610-0279
(352) 594-1942

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9112353
FL
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104080300
FL
Enumeration date
03/19/2019
Last updated
10/05/2021
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