| NPI | 1992338511 |
|---|---|
| Former Name | AMANDA ROSE POUSSARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2351351) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN287902) |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2026-07-28 |