Provider Demographics
NPI:1154071553
Name:HOPE, AMANDA H
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:H
Last Name:HOPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2777
Mailing Address - Country:US
Mailing Address - Phone:508-880-1598
Mailing Address - Fax:508-880-8937
Practice Address - Street 1:66 MAIN ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2777
Practice Address - Country:US
Practice Address - Phone:508-880-1598
Practice Address - Fax:508-880-8937
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN97893164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse