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Individual

AMANDA MARY COMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
295 LAFAYETTE ST # 7TH, NEW YORK, NY 10012-2701
(414) 418-5357
Mailing address
86227 DEBBIE RD, YULEE, FL 32097-2975
(414) 418-5357

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN61271056
WA
163W00000X
Registered Nurse
Primary
RN9529728
FL

Other

Enumeration date
07/19/2022
Last updated
07/19/2022
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