Provider Demographics
NPI:1669912606
Name:COPELAND, AMANDA (ARNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:COPELAND
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 1:407 WEKIVA SPRINGS RD STE 123
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-6157
Mailing Address - Country:US
Mailing Address - Phone:407-790-7998
Mailing Address - Fax:
Practice Address - Street 1:407 WEKIVA SPRINGS RD STE 123
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-6157
Practice Address - Country:US
Practice Address - Phone:407-790-7998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9325933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily