Provider Demographics
NPI:1497358105
Name:ANAZIA, AMANDA (PMHNP-BC, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:
Last Name:ANAZIA
Suffix:
Gender:F
Credentials:PMHNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 CROMARTY CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5872
Mailing Address - Country:US
Mailing Address - Phone:512-689-0665
Mailing Address - Fax:
Practice Address - Street 1:8140 N MOPAC EXPY BLDG 3
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8837
Practice Address - Country:US
Practice Address - Phone:512-535-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX820468163W00000X
TX1032987363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily