Healthcare Provider Details

I. General information

NPI: 1952888398
Provider Name (Legal Business Name): AMY ELIZABETH DELUCA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2018
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 SOUTHBRIDGE ST
AUBURN MA
01501-2548
US

IV. Provider business mailing address

207 SOUTHBRIDGE ST
AUBURN MA
01501-2548
US

V. Phone/Fax

Practice location:
  • Phone: 508-832-7118
  • Fax: 508-832-7166
Mailing address:
  • Phone: 508-832-7118
  • Fax: 508-832-7166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2273293
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9968
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: