Healthcare Provider Details

I. General information

NPI: 1306537311
Provider Name (Legal Business Name): AMANDA HELLWEGE WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 NJ-66 #400
NEPTUNE NJ
07753
US

IV. Provider business mailing address

1921 GREVE AVE APT B
SPRING LAKE NJ
07762-2358
US

V. Phone/Fax

Practice location:
  • Phone: 732-363-6655
  • Fax:
Mailing address:
  • Phone: 732-272-5237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ01417400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: