Provider Demographics
NPI:1265530471
Name:SMITH, AMY ELIZABETH (ARNP)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2500 VETERANS WAY
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32408-2437
Mailing Address - Country:US
Mailing Address - Phone:850-636-9400
Mailing Address - Fax:850-636-9425
Practice Address - Street 1:2500 VETERANS WAY
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32408-2437
Practice Address - Country:US
Practice Address - Phone:850-636-9400
Practice Address - Fax:850-636-9425
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2907782363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE5948ZMedicare PIN