Healthcare Provider Details

I. General information

NPI: 1790068823
Provider Name (Legal Business Name): EVE AMENDOLA N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2011
Last Update Date: 06/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 RAILROAD AVE
SOUTH HAMILTON MA
01982-2218
US

IV. Provider business mailing address

15 RAILROAD AVE
SOUTH HAMILTON MA
01982-2218
US

V. Phone/Fax

Practice location:
  • Phone: 978-468-7381
  • Fax:
Mailing address:
  • Phone: 978-468-7381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2264139
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: