Provider Demographics
NPI:1366825838
Name:KRUPSKI, AMY (CNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:KRUPSKI
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:SURLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:36 ADAMS STREET
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169
Mailing Address - Country:US
Mailing Address - Phone:617-773-9805
Mailing Address - Fax:617-773-5400
Practice Address - Street 1:36 ADAMS STREET
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169
Practice Address - Country:US
Practice Address - Phone:617-773-0711
Practice Address - Fax:617-472-5400
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2295178364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology