Healthcare Provider Details

I. General information

NPI: 1447956313
Provider Name (Legal Business Name): AMANDA BRENNAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2023
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 GONIC RD STE 2A
ROCHESTER NH
03839-5689
US

IV. Provider business mailing address

323 GONIC RD STE 2A
ROCHESTER NH
03839-5689
US

V. Phone/Fax

Practice location:
  • Phone: 603-802-3953
  • Fax: 603-803-5511
Mailing address:
  • Phone: 603-802-3953
  • Fax: 603-803-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number053618-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: