Healthcare Provider Details

I. General information

NPI: 1942881958
Provider Name (Legal Business Name): AMANDA ADKINS CM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 04/20/2021
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 MAIN ST
BUFFALO NY
14214-2008
US

IV. Provider business mailing address

11045 ELDREDGE RD
CATTARAUGUS NY
14719-9747
US

V. Phone/Fax

Practice location:
  • Phone: 716-835-2510
  • Fax:
Mailing address:
  • Phone: 716-908-2089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number002068
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: