Amanda Leigh Perry, DNP, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Cooperstown, ND
NPI 1003046616 · NPPES record last updated Dec 9, 2016
Key facts
- NPI
- 1003046616
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R41616 (ND)
- Practice address
- 665 112TH Ave NE
Cooperstown, ND 58425-9264 - Phone
- (601) 870-0774
- Fax
- (701) 797-3328
- NPI assigned
- Jul 16, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R863756 | MS | MD | Nurse Practitioner |
Interoperability endpoints
- https://api.platform.athenahealth.com/18068/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R41616 | ND | Yes |
| Nurse Practitioner | 363L00000X | R863756 | MS |
Addresses
Primary practice location
665 112TH Ave NE
Cooperstown, ND 58425-9264
Mailing address
665 112TH Ave NE
Cooperstown, ND 58425-9264
Phone (601) 870-0774
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07736054 | Medicaid | MS |
Other providers in Cooperstown, ND
- Kristine Louise Martin
- William G McKinnon
- Debra L. Middleton
- Outlook Chiropractic
- Leon Donald Paczkowski
- Pharmacists Associates LLC
- Sarah Ressler
- Ashley N Stockeland
All providers in Cooperstown, ND · Family Nurse Practitioner in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.