Provider Demographics
NPI:1700340908
Name:FLOYD, AMY LYNN (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:FLOYD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5681 HIGHWAY 363
Mailing Address - Street 2:
Mailing Address - City:MANTACHIE
Mailing Address - State:MS
Mailing Address - Zip Code:38855-7632
Mailing Address - Country:US
Mailing Address - Phone:662-282-4226
Mailing Address - Fax:662-282-4231
Practice Address - Street 1:5681 HIGHWAY 363
Practice Address - Street 2:
Practice Address - City:MANTACHIE
Practice Address - State:MS
Practice Address - Zip Code:38855-7632
Practice Address - Country:US
Practice Address - Phone:662-282-4226
Practice Address - Fax:662-282-7946
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903217363LF0000X
AL1-119261363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSR877126OtherRN LICENSE