Provider Demographics
NPI:1124815766
Name:DAMICO, AMANDA ELIZABETH (FNP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:ELIZABETH
Last Name:DAMICO
Suffix:
Gender:
Credentials:FNP
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:ELIZABETH
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1414 PHYSICIANS DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7335
Mailing Address - Country:US
Mailing Address - Phone:910-796-7900
Mailing Address - Fax:
Practice Address - Street 1:2131 S 17TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7407
Practice Address - Country:US
Practice Address - Phone:910-667-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF09230660363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily