Provider Demographics
NPI:1275938052
Name:REPASS, AMANDA (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:REPASS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:PIOTROWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:2406 CENTURY PL SE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4031
Mailing Address - Country:US
Mailing Address - Phone:828-324-9550
Mailing Address - Fax:
Practice Address - Street 1:2406 CENTURY PL SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4031
Practice Address - Country:US
Practice Address - Phone:828-324-9550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007279363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health