Provider Demographics
NPI:1932562097
Name:SCHULTZ, AMANDA DYANE (ARNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:DYANE
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:PRATUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:730 GOODLETTE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5617
Mailing Address - Country:US
Mailing Address - Phone:239-263-0849
Mailing Address - Fax:
Practice Address - Street 1:730 GOODLETTE RD # 180
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5616
Practice Address - Country:US
Practice Address - Phone:239-263-0849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-05
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9286937363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner