Individual
AMANDA JEAN LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
400 CROOKED HILL RD, BRENTWOOD, NY 11717-1039
(631) 231-3232
Mailing address
80 MANOR DR, SHIRLEY, NY 11967-4306
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
355090-01
NY
Other
Enumeration date
12/02/2025
Last updated
12/02/2025
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