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General NPI Number Information
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NPI Number | 1376362814
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Entity Type | Individual
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Provider Name | AMANDA PAOLINA CREUTZ MSN, AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 195 LITTLE ALBANY ST
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1914
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Country | US
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Telephone | 732-235-2465
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Fax | 732-235-5795
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Provider Business Mailing Address
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Address Line | 195 LITTLE ALBANY ST
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1914
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Country | US
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Telephone | 732-235-2465
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ15148100
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License Number State | NJ
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