Provider Demographics
NPI:1295937308
Name:DAVIS, AMANDA (CNM)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:280 UNION ST
Mailing Address - Street 2:LYNN WOMEN'S HEALTH
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1353
Mailing Address - Country:US
Mailing Address - Phone:781-596-3800
Mailing Address - Fax:781-596-3830
Practice Address - Street 1:280 UNION ST
Practice Address - Street 2:LYNN WOMEN'S HEALTH
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1353
Practice Address - Country:US
Practice Address - Phone:781-596-3800
Practice Address - Fax:781-596-3830
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2018-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA239226163WM0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn