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Amanda Vickery, NP
Adult Health Nurse Practitioner in Boston, Massachusetts
NPI 1073617528

Amanda Vickery is an Adult Health Nurse Practitioner based in Boston, MA and is specialized in Adult Health. Amanda Vickery practices in Boston, MA and has the professional credentials of NP. The NPI Number for Amanda Vickery is 1073617528 and holds a License No. 195282 (Massachusetts).

The current practice location address for Amanda Vickery is 55 Fruit Street Cln 115, Boston, MA and can be reached out via phone at 617-724-8810.

Location: 55 Fruit Street Cln 115, Boston, MA, 02114
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073617528
Provider Name
Amanda Vickery
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
55 Fruit Street Cln 115, Boston, MA, 02114
Phone Number
617-724-8810
Fax Number
Provider Enumeration Date
09/12/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0357090 05 MA
NP2897 01 MA BCBS
institution
Provider Business Practice Location Address Details
Address
55 Fruit Street Cln 115
City
Boston
State
Massachusetts
Zip
02114
Phone Number
617-724-8810
Fax Number
person
Provider Business Mailing Address Details
Address
55 Fruit Street Cln 115
City
Boston
State
Massachusetts
Zip
02114
Phone Number
617-724-8810
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
363LA2200X
License No.
195282 (Massachusetts)
Definition
Definition to come...
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