Provider Demographics
NPI:1235351677
Name:THOMAS, AMY C (ANP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:THOMAS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:W
Other - Last Name:CHATELLIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 TURNER ST
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-3748
Mailing Address - Country:US
Mailing Address - Phone:781-856-2912
Mailing Address - Fax:
Practice Address - Street 1:8 KILBURN ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-7321
Practice Address - Country:US
Practice Address - Phone:508-979-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN163819363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner