AMANDA MACKILLOP

SOUTHOLD, NY
NPI1770128753
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NY  403484)
Additional Taxonomies163W00000X Registered Nurse
(Licence: NY  780342)
Enumeration Date2019-11-13
Last Update Date2025-12-17
Business Address
AMANDA MACKILLOP NP
54655 MAIN RD
SOUTHOLD, NY 11971-4769
Phone number: 631-301-2271
Mailing Address
AMANDA MACKILLOP NP
54655 MAIN RD
SOUTHOLD, NY 11971-4769
Phone number: 631-301-2271