Amanda Provost, RN
Individual provider Active NPI Registered Nurse · Shirley, MA
NPI 1720733355 · NPPES record last updated Feb 11, 2022
Key facts
- NPI
- 1720733355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN2327150 (MA)
- Practice address
- 12B Squannacook Rd
Shirley, MA 01464-2348 - Phone
- (978) 870-2781
- NPI assigned
- Feb 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2327150 | MA | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN2327150 | MA | Yes |
Addresses
Primary practice location
12B Squannacook Rd
Shirley, MA 01464-2348
Mailing address
12B Squannacook Rd
Shirley, MA 01464-2348
Phone (978) 870-2781
Other providers in Shirley, MA
- Irene Marvis Mutayomba
- Nashoba Pediatric Therapies, LLC
- Bartholomew Nelson
- Susan Margaret Ott
- Muriel C Peterson
- Kathleen M Reardon
- Risk Managment Incorporated
- Shirley Dental Care, Inc
- Shirley School District
- Tiffany Tiana Smith
All providers in Shirley, MA · Registered Nurse in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2022. 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.