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NPI 1689945420

NPI 1689945420 : AMANDA ELIZABETH MAGNOLI ANP-BC : WESTBROOK, ME

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General NPI Number Information
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    NPI Number           |    1689945420
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    Entity Type          |    Individual 
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    Provider Name        |    AMANDA ELIZABETH MAGNOLI ANP-BC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/25/2012
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    Last Update Date     |    11/18/2025
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Provider Practice Location Address
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    Address Line         |    11 ROCK ROW STE 120 
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    City                 |    WESTBROOK
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    State                |    ME
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    Zip                  |    04092-4877
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    Country              |    US
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    Telephone            |    207-303-3300
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    Fax                  |    207-250-2137
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Provider Business Mailing Address
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    Address Line         |    PO BOX 911 
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    City                 |    BRATTLEBORO
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    State                |    VT
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    Zip                  |    05302-0911
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    Country              |    US
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    Telephone            |    207-303-3200
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    Fax                  |    207-250-2140
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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        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    846102
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    363LA2200X
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    Taxonomy Name        |    Adult Health Nurse Practitioner
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    License Number       |    004742
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    License Number State |    CT
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Taxonomy #3
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    Taxonomy Code        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    CNP151089
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    License Number State |    ME
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