Provider Demographics
NPI:1053835975
Name:AMATUCCI, VANESSA R (APRN)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:R
Last Name:AMATUCCI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CLARK WAY
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-4401
Mailing Address - Country:US
Mailing Address - Phone:603-692-2228
Mailing Address - Fax:603-692-4748
Practice Address - Street 1:21 CLARK WAY
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-4401
Practice Address - Country:US
Practice Address - Phone:603-692-2228
Practice Address - Fax:603-692-4748
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH060308-23363L00000X, 363LF0000X
MARN276072363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily