Provider Demographics
NPI:1376998914
Name:COFFEY, AMANDA (FNP)
Entity Type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:
Last Name:COFFEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 KIMBALL LN STE 120
Mailing Address - Street 2:LAHEY HEALTH PRIMARY CARE, LYNNFIELD
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940-2667
Mailing Address - Country:US
Mailing Address - Phone:781-213-4040
Mailing Address - Fax:781-213-5064
Practice Address - Street 1:6 KIMBALL LN STE 120
Practice Address - Street 2:LAHEY HEALTH PRIMARY CARE, LYNNFIELD
Practice Address - City:LYNNFIELD
Practice Address - State:MA
Practice Address - Zip Code:01940-2667
Practice Address - Country:US
Practice Address - Phone:781-213-4040
Practice Address - Fax:781-213-5064
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2266756363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily