Individual
AMY LUCAS GREAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
137 MAIN ST, NEWPORT, VT 05855-4415
(802) 995-2412
(802) 334-7991
Mailing address
165 SHERMAN DR, SAINT JOHNSBURY, VT 05819-9811
(802) 748-9405
(802) 748-4540
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055.0031667
VT
363A00000X
Physician Assistant
0968
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055.0031667
VT STATE LICENSE
VT
01
—
0968
NH LICENSE
NH
Enumeration date
08/08/2013
Last updated
04/02/2025
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