Provider Demographics
NPI:1376793547
Name:LEE, AMANDA (RN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:RN, CRNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:BEATTIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34TH AND CIVIC CENTER BLVD
Mailing Address - Street 2:DIVISION OF ENDOCRINOLOGY SUITE 11NW30
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:267-426-7040
Mailing Address - Fax:
Practice Address - Street 1:1 ROBERT WOOD JOHNSON PL FL 1
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1928
Practice Address - Country:US
Practice Address - Phone:732-828-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009295363LP0200X
NJ26NJ00749900363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics