Provider Demographics
NPI:1316544000
Name:HOLZWORTH, AMY LEANNE (ARNP-BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEANNE
Last Name:HOLZWORTH
Suffix:
Gender:F
Credentials:ARNP-BC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LEANNE
Other - Last Name:HARSHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP-BC
Mailing Address - Street 1:5113 HORSESHOE PL NE
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-4129
Mailing Address - Country:US
Mailing Address - Phone:765-252-8142
Mailing Address - Fax:
Practice Address - Street 1:1055 S FORT HARRISON AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3905
Practice Address - Country:US
Practice Address - Phone:727-442-6245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005745363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner