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Individual
AMANDA REGAN REILLY
Active
Individual
AMANDA REGAN REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704419007
MI
363LP0200X
Pediatric Nurse Practitioner
25148081703
MI
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2336550
MA
Other
Enumeration date
06/19/2025
Last updated
04/16/2026
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