Provider Demographics
NPI:1669992921
Name:CROFT, AMANDA KAYE ELIZABETH (ARNP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:KAYE ELIZABETH
Last Name:CROFT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:KAYE ELIZABETH
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8314 SW 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-3655
Mailing Address - Country:US
Mailing Address - Phone:423-991-9161
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 100186
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0186
Practice Address - Country:US
Practice Address - Phone:352-733-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9327815363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021608800Medicaid
FLJC250ZOtherMEDICARE