MEDICARE: DR. MARIA AMADI AGNP-C, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	0024177312	VA
2	363LP2300X	Primary Care Nurse Practitioner	0024177312	VA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024177312	VA

General Provider Information

NPI Number	:	1881155109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA AMADI AGNP-C, PMHNP-BC

Provider Business Mailing Address
First Line	:	1245G CEDAR RD # 225
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23322-7103
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3804 POPLAR HILL RD STE D
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23321-5532
Country	:	US
Telephone Number	:	757-210-9381
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2019
Last Update Date	:	04/04/2025

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