Provider Demographics
NPI:1912335811
Name:LABRON, AMY LYNNE (APRN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNNE
Last Name:LABRON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8936 77TH TER E UNIT 101
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-6419
Mailing Address - Country:US
Mailing Address - Phone:941-758-7300
Mailing Address - Fax:
Practice Address - Street 1:8936 77TH TER E UNIT 101
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-6419
Practice Address - Country:US
Practice Address - Phone:941-758-7300
Practice Address - Fax:941-758-7334
Is Sole Proprietor?:No
Enumeration Date:2013-10-31
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001624363LF0000X, 363LF0000X
TNAPN18226363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY885840OtherANTHEM BC OF KY
TN6007412OtherBCBS OF TN
TNQ005002Medicaid
FL102620200Medicaid
KY7100272890Medicaid
TN103I053376Medicare PIN