Provider Demographics
NPI:1306029970
Name:HARDING, AMY E (NP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:HARDING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:E
Other - Last Name:MICHALEWICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:830 OAK ST
Mailing Address - Street 2:SUITE 223E
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-1168
Mailing Address - Country:US
Mailing Address - Phone:508-586-3683
Mailing Address - Fax:508-586-6052
Practice Address - Street 1:830 OAK ST
Practice Address - Street 2:SUITE 223E
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1168
Practice Address - Country:US
Practice Address - Phone:508-586-3683
Practice Address - Fax:508-586-6052
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235585363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health