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NPI Code Detail

MEDICARE: AMANDA JEANNE COLEMAN APRN

MEDICARE: AMANDA JEANNE COLEMAN APRN
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 Practitioner064353-23NH

General Provider Information

NPI Number : 1720568322
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA JEANNE COLEMAN APRN
Provider Business Mailing Address
First Line : 16 HILLS RD
Second Line :
City : HOOKSETT
State : NH
Zip : 03106-2190
Country : US
Telephone Number : 603-493-3091
Fax Number :
Provider Business Practice Location Address
First Line : 3 NASHUA RD
Second Line :
City : BEDFORD
State : NH
Zip : 03110-5515
Country : US
Telephone Number : 603-472-6700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2018
Last Update Date : 08/14/2018

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