Individual
AMANDA BROADNAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
63 EARL PL, BUFFALO, NY 14211-2904
(585) 690-1217
Mailing address
63 EARL PL, BUFFALO, NY 14211-2904
(585) 690-1217
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
853739
NY
Other
Enumeration date
03/04/2026
Last updated
03/04/2026
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