Provider Demographics
NPI:1033904065
Name:CONNERTON, AMANDA (APRN-CNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:CONNERTON
Suffix:
Gender:
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 FERRIS CRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-5599
Mailing Address - Country:US
Mailing Address - Phone:203-278-0473
Mailing Address - Fax:
Practice Address - Street 1:45 FERRIS CRK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-5599
Practice Address - Country:US
Practice Address - Phone:203-278-0473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1023942363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner