Provider Demographics
NPI:1699352484
Name:NASS, AMANDA MARTHA (PA-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARTHA
Last Name:NASS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MARTHA
Other - Last Name:WOROBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:850 KEMPSVILLE RD STE 200B
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3920
Mailing Address - Country:US
Mailing Address - Phone:757-261-5999
Mailing Address - Fax:757-466-0321
Practice Address - Street 1:850 KEMPSVILLE RD STE 200B
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-261-5999
Practice Address - Fax:757-466-0321
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-26
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9113988363A00000X
VA0110008787363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant