| NPI | 1821513672 |
|---|---|
| Former Name | AMANDA MARIE WORMLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342073-1) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 342073) |
| Enumeration Date | 2017-08-12 |
| Last Update Date | 2023-06-29 |