Provider Demographics
NPI:1669613774
Name:PARENT, AMANDA JEAN (CRNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:JEAN
Last Name:PARENT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:JEAN
Other - Last Name:SELLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3701 MARKET STREET
Mailing Address - Street 2:6TH FLOOR, SUITE 640
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5508
Mailing Address - Country:US
Mailing Address - Phone:215-662-2250
Mailing Address - Fax:
Practice Address - Street 1:3701 MARKET STREET
Practice Address - Street 2:6TH FLOOR, SUITE 640
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5508
Practice Address - Country:US
Practice Address - Phone:215-662-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-19
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010229363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily