AMANDA MAE DISTIN NPI 1487598769

NPI Information

  • NPI: 1487598769
  • Provider Name: AMANDA MAE DISTIN
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • Address: 682 E EAGLE AVE
    EAGLE LAKE, FL
    ZIP 33839
  • Phone: (440) 417-4482

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NPI Details

Amanda Mae Distin is a psychiatric/mental health nurse practitioner in Eagle Lake, FL. Amanda Mae Distin NPI is 1487598769. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

682 E EAGLE AVE
EAGLE LAKE, FL
ZIP 33839-238
Phone: (440) 417-4482

The enumeration date for this NPI number is 4/16/2026 and was last updated on 4/16/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN11046724FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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