Provider Demographics
NPI:1932373412
Name:CHALLENGER, AMY (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:CHALLENGER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 NW 84TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1847
Mailing Address - Country:US
Mailing Address - Phone:954-635-6243
Mailing Address - Fax:954-635-6246
Practice Address - Street 1:350 NW 84TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1847
Practice Address - Country:US
Practice Address - Phone:954-635-6243
Practice Address - Fax:954-635-6246
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9181634363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology