Healthcare Provider Details

I. General information

NPI: 1619494846
Provider Name (Legal Business Name): AMANDA LINDSAY HALL MSN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 OMEGA DR
NEWARK DE
19718-4515
US

IV. Provider business mailing address

1400 TURKEY POINT RD
NORTH EAST MD
21901-5212
US

V. Phone/Fax

Practice location:
  • Phone: 443-907-7900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLG-0001094
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-00001094
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number7603
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0038056
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: