Provider Demographics
NPI:1538545751
Name:AMOROSO, HALIE LAURA (NP-C)
Entity type:Individual
Prefix:MRS
First Name:HALIE
Middle Name:LAURA
Last Name:AMOROSO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8605 RIDGELYS CHOICE DR
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-2953
Mailing Address - Country:US
Mailing Address - Phone:410-248-2310
Mailing Address - Fax:
Practice Address - Street 1:8605 RIDGELYS CHOICE DR
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-2953
Practice Address - Country:US
Practice Address - Phone:410-248-2310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR200699363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily