Outly, Amanda Michelle

Outly, Amanda Michelle is an individual health care provider with primary practice located at 2001 E. Highway 20 Family Medicine Department, Niceville FL 32578-8826. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Outly, Amanda Michelle can be contacted via phone (850) 897-6600.

Contact Information

Primary practice address
2001 E. Highway 20 Family Medicine Department Niceville FL 32578-8826
Phone: (850) 897-6600
Fax: (850) 897-0623
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9110768 Florida

Profile Details

NPI number 1003298969
LBN Legal business name Outly, Amanda Michelle
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2015
Last updated Jan 17th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003298969 NPPES
Florida Other N3KG2 BCBSFL
Florida MEDICAID 022418500 BCBSFL

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