MEDICARE: MRS. ANN BERRY AMYOT NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	163099	NC

General Provider Information

NPI Number	:	1558356865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANN BERRY AMYOT NP

Provider Business Mailing Address
First Line	:	3559 BENTRIDGE DR
Second Line	:
City	:	MEBANE
State	:	NC
Zip	:	27302-8640
Country	:	US
Telephone Number	:	919-304-6767
Fax Number	:

Provider Business Practice Location Address
First Line	:	2797 NC 55 HWY
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27519-6206
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:	401-652-9787

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	04/14/2015

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