Provider Demographics
NPI:1770148660
Name:EGLI, AMANDA L (APRN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:EGLI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:L
Other - Last Name:EGLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10 JONES RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-3100
Mailing Address - Country:US
Mailing Address - Phone:603-672-7600
Mailing Address - Fax:
Practice Address - Street 1:10 JONES RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-3100
Practice Address - Country:US
Practice Address - Phone:603-627-7600
Practice Address - Fax:603-672-6274
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2267298363LF0000X
NH006768-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily