Healthcare Provider Details

I. General information

NPI: 1063811719
Provider Name (Legal Business Name): AMY ELIZABETH RICHANE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 05/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 LOCUST ST
NORTHAMPTON MA
01060-2052
US

IV. Provider business mailing address

30 LOCUST ST
NORTHAMPTON MA
01060-2052
US

V. Phone/Fax

Practice location:
  • Phone: 413-582-2000
  • Fax:
Mailing address:
  • Phone: 413-582-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN2293639
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: