Provider Demographics
NPI:1881482560
Name:MCCORKLE, AMANDA RENEE (FNP-BC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:RENEE
Last Name:MCCORKLE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 GRAND RAPIDS BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-4467
Mailing Address - Country:US
Mailing Address - Phone:239-340-0300
Mailing Address - Fax:
Practice Address - Street 1:1333 3RD AVE S STE 402
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6535
Practice Address - Country:US
Practice Address - Phone:239-352-5550
Practice Address - Fax:239-352-5545
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11038859363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily