Provider Demographics
NPI:1346214145
Name:STONE, AMY NICOLE (ARNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:NICOLE
Last Name:STONE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6072 DOCTORS PARK
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-5072
Mailing Address - Country:US
Mailing Address - Phone:850-983-3528
Mailing Address - Fax:850-983-3546
Practice Address - Street 1:6072 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-5072
Practice Address - Country:US
Practice Address - Phone:850-983-3528
Practice Address - Fax:850-983-3546
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3263522363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307509500Medicaid
FLQ68186Medicare PIN