Amanda Marie Spence, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

ARNP9404125 Issued in FL

Practice address

4266 Sunbeam Rd
Jacksonville, FL 32257-2425

Phone

(904) 463-4770

Fax

(904) 202-8549

NPI assigned

Aug 1, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Amanda Mazur Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1093147019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572425",
            "telephone_number": "904-463-4770",
            "fax_number": "904-202-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572425",
            "telephone_number": "904-463-4770",
            "fax_number": "904-202-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9404125",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "COA14920-NP,RN344880",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MAZUR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leigh Speicher, MD
• Abigail Lynn Speights
• Susan Gail Spell, APRN
• Sarah Catherine Spelsberg, MD, FAWM, FEWM, PAC
• Alexandra Marie Spence, APRN
• Danielle Alexandria Spence, APRN
• Kimberly Spence
• Luke Spencer-Gardner, MD
• Ashley A Spencer, ARNP
• Cozetta Antoinette Spencer, B.A.

• Pediatric Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.