Healthcare Provider Details

I. General information

NPI: 1053981514
Provider Name (Legal Business Name): AMANDA M. HULINGS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 06/28/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 S BEDFORD ST
BURLINGTON MA
01803-5108
US

IV. Provider business mailing address

3 GRACEFUL WAY
WESTFORD MA
01886-1970
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-5100
  • Fax:
Mailing address:
  • Phone: 978-828-4289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN274339
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: