Provider Demographics
NPI:1619105053
Name:GAGNE, AMY LEE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LEE
Last Name:GAGNE
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Gender:F
Credentials:FNP
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Mailing Address - Street 1:427 GUY PARK AVE - PRIMARY & SPECIALTY CARE DEPT.
Mailing Address - Street 2:ST. MARY'S HOSPITAL AT AMSTERDAM
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010
Mailing Address - Country:US
Mailing Address - Phone:518-841-7430
Mailing Address - Fax:518-841-7121
Practice Address - Street 1:84 E STATE ST
Practice Address - Street 2:ST. MARY'S HOSPITAL, GLOVERSVILLE FAMILY HEALTH CENTER
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078
Practice Address - Country:US
Practice Address - Phone:518-773-8894
Practice Address - Fax:518-773-8125
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2010-09-21
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Provider Licenses
StateLicense IDTaxonomies
NYF335920-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily