Provider Demographics
NPI:1578189981
Name:BURNS, AMY LOUISE (ARNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LOUISE
Last Name:BURNS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:SIERRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4700 THAT ST
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-9723
Mailing Address - Country:US
Mailing Address - Phone:352-326-5281
Mailing Address - Fax:352-323-1761
Practice Address - Street 1:4700 THAT ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-9723
Practice Address - Country:US
Practice Address - Phone:352-326-5281
Practice Address - Fax:352-323-1761
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007460363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty