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General NPI Number Information
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NPI Number | 1942003413
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Entity Type | Individual
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Provider Name | AMANDA MACKANOS PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 18-1228 KONA STREET
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City | MOUNTAIN VIEW
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State | HI
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Zip | 96771
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Country | US
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Telephone | 808-797-2621
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Fax | 808-452-1306
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Provider Business Mailing Address
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Address Line | 301 WHITE OAK RD
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City | SOMERSET
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State | PA
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Zip | 15501-8548
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Country | US
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Telephone | 814-937-9315
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP032496
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10045008
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN-5157
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License Number State | HI
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