Provider Demographics
NPI:1407827421
Name:BORDEN, AMY JEAN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:JEAN
Last Name:BORDEN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7740 HAVERHILL CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-9483
Mailing Address - Country:US
Mailing Address - Phone:239-877-7433
Mailing Address - Fax:
Practice Address - Street 1:11161 HEALTH PARK BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-5730
Practice Address - Country:US
Practice Address - Phone:239-234-2620
Practice Address - Fax:239-234-2622
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9221160367500000X
FLAPRN9221160367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG3590ZOtherRAILROAD MEDICARE
FLG3590OtherBC/BS FL
FLG3590OtherBC/BS FL