Provider Demographics
NPI:1891729067
Name:SAGER, AMANDA CLARE (NP-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:CLARE
Last Name:SAGER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 W PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:AVON PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33825-2966
Mailing Address - Country:US
Mailing Address - Phone:863-453-3121
Mailing Address - Fax:863-452-2823
Practice Address - Street 1:1006 W PLEASANT ST
Practice Address - Street 2:
Practice Address - City:AVON PARK
Practice Address - State:FL
Practice Address - Zip Code:33825-2966
Practice Address - Country:US
Practice Address - Phone:863-453-3121
Practice Address - Fax:863-452-2823
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000005536363LF0000X
FLARNP9267346363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308728000Medicaid
TN3342827Medicaid
P00329466OtherRAILROAD MEDICARE
TN4140513OtherBCBS-TN
TN4140513OtherBCBS-TN
FL308728000Medicaid