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NPI Code Detail

MEDICARE: AMANDA CHRISTINE CARDILLO

MEDICARE:   AMANDA CHRISTINE CARDILLO
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
1363LF0000XFamily Nurse PractitionerRN.511495OH

General Provider Information

NPI Number : 1578418810
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA CHRISTINE CARDILLO
Provider Business Mailing Address
First Line : 111 NEW HAMPSHIRE AVE STE 2
Second Line :
City : PORTSMOUTH
State : NH
Zip : 03801-2864
Country : US
Telephone Number : 330-651-1872
Fax Number :
Provider Business Practice Location Address
First Line : 987 BOARDMAN CANFIELD RD
Second Line :
City : BOARDMAN
State : OH
Zip : 44512-4222
Country : US
Telephone Number : 330-965-8760
Fax Number : 330-965-9325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/12/2026

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Directions to “ AMANDA CHRISTINE CARDILLO ” Practice Location

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