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Individual

AMANDA PROVOST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
12B SQUANNACOOK RD, SHIRLEY, MA 01464-2348
(978) 870-2781
Mailing address
12B SQUANNACOOK RD, SHIRLEY, MA 01464-2348
(978) 870-2781

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2327150
MA

Other

Enumeration date
02/11/2022
Last updated
02/11/2022
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