Provider Demographics
NPI:1497834501
Name:NILGES, AMY MARIE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:NILGES
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:YEARGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:312 MARLBORO ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-4163
Mailing Address - Country:US
Mailing Address - Phone:603-352-2253
Mailing Address - Fax:
Practice Address - Street 1:1 VERNEY DR
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:NH
Practice Address - Zip Code:03047-5000
Practice Address - Country:US
Practice Address - Phone:603-547-3311
Practice Address - Fax:603-547-3232
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1857225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30414470Medicaid