Healthcare Provider Details

I. General information

NPI: 1730441445
Provider Name (Legal Business Name): AMANDA KATHLEEN HEGNAUER N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2012
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 NEWPORT RD STE 107
NEW LONDON NH
03257-5468
US

IV. Provider business mailing address

PO BOX 102
HOPKINTON NH
03229-0102
US

V. Phone/Fax

Practice location:
  • Phone: 603-526-4144
  • Fax: 603-526-4167
Mailing address:
  • Phone: 603-715-2816
  • Fax: 603-635-4845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number92
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: