Individual
AMANDA JUTRAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 DOCTORS PARK, LINCOLNTON, NC 28092-4407
(704) 735-1441
(704) 735-1472
Mailing address
968 HAMPTON RD, POMFRET CENTER, CT 06259-2017
(860) 539-8952
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
349451
NC
363LP0200X
Pediatric Nurse Practitioner
Primary
33U8W
NC
Other
Enumeration date
07/05/2021
Last updated
04/24/2023
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