Provider Demographics
NPI:1316582331
Name:GEORGE, AMANDA J (APN)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:J
Last Name:GEORGE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 MADISON AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7360
Mailing Address - Country:US
Mailing Address - Phone:973-540-9700
Mailing Address - Fax:973-540-9717
Practice Address - Street 1:131 MADISON AVE STE 2
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7360
Practice Address - Country:US
Practice Address - Phone:973-540-9700
Practice Address - Fax:973-540-9717
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00985300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner