Individual
MRS. AMANDA MICHELLE NORTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3600 HIGH ST, PORTSMOUTH, VA 23707-3236
(757) 215-3100
(757) 398-9263
Mailing address
3600 HIGH ST, PORTSMOUTH, VA 23707-3236
(757) 215-3100
(757) 398-9263
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024172143
VA
Other
Enumeration date
12/02/2014
Last updated
12/02/2014
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