Amanda Rose Wilson, NP
Nurse Practitioner, Acute Care in Rochester, NY. Individual provider (NPI-1).
NPI number1164025672
StatusActive
Last updated in NPPESJan 18, 2021
Details
- NPI
- 1164025672
- Entity type
- Individual (NPI-1)
- Name
- Amanda Rose Wilson
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 17, 2020
- Certification date
- Jan 18, 2021
- Last updated
- Jan 18, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2100X | Nurse Practitioner, Acute Care | 431739 | NY | Yes |
| 163WC0200X | Registered Nurse, Critical Care Medicine | 701776 | NY | |
| 363LG0600X | Nurse Practitioner, Gerontology | 431739 | NY |
Practice location
89 Genesee StRochester, NY 14611-3201
Phone 585-723-7000
Mailing address
100 Kings Hwy SRochester, NY 14617-5504
Phone 585-474-1224
Other practice locations
1425 Portland Ave
Rochester, NY 14621-3011
Rochester, NY 14621-3011
Phone 585-922-5067 · Fax 585-922-2905
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