IndividualActive
Amanda Willard, APRN
NPI 1174305098 · Family Nurse Practitioner · Interlachen, FL
Provider details
- NPI number
- 1174305098
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- Yes
- License
- 11029179 (FL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1213 State Road 20
Interlachen, FL 32148-2737
Phone: (904) 698-9098
Approximate (ZIP-level) locationGet directions
Mailing address
1302 River St
Palatka, FL 32177-5042
Registry dates
- Enumerated
- 2023-10-16
- Last updated
- 2024-04-03
- Certified
- 2024-04-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.