Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amanda Shively

Individual provider Family Nurse Practitioner · NPI 1982202412

Amanda Shively is a Nurse Practitioner in Fort Myers, Florida. Qualified in 2020, 6 years ago. Practices with Millennium Physician Group LLC, a 970-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
6
Licensed in
FL
In the registry since
2020
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Practice location Address checks out

2675 Winkler Ave Fl 2
Fort Myers, FL 33901-9342
Phone: (855) 979-5700
Fax: (855) 979-5701
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN11009633 (FL)

Record details

NPI number1982202412
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 16, 2020
Last updated in NPPESJanuary 18, 2024
Certification dateJanuary 18, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Millennium Physician Group Llc — 970 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Fort Myers