Provider Demographics
NPI:1356006985
Name:BERNATCHY, AMANDA LEE (NP)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:LEE
Last Name:BERNATCHY
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:960 MASSACHUSETTS AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:725 ALBANY STREET, SUITE 7C
Practice Address - Street 2:SHAPIRO BLDG
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2526
Practice Address - Country:US
Practice Address - Phone:617-414-8680
Practice Address - Fax:617-414-8664
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2024-02-15
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Provider Licenses
StateLicense IDTaxonomies
MARN2307824163WM0705X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical