Provider Demographics
NPI:1841565793
Name:GIRARD, AMANDA LOUISE (RN FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:LOUISE
Last Name:GIRARD
Suffix:
Gender:F
Credentials:RN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10187 BUFFTON DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-5205
Mailing Address - Country:US
Mailing Address - Phone:314-258-1038
Mailing Address - Fax:
Practice Address - Street 1:611 S HOWARD AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2412
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-11
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11026939363LF0000X
MO2011039059363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily