Provider Demographics
NPI:1285324889
Name:SIEMANOWICZ, AMY LYNN (APRN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:SIEMANOWICZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 KNOLLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-4339
Mailing Address - Country:US
Mailing Address - Phone:603-493-1850
Mailing Address - Fax:
Practice Address - Street 1:145 HOLLIS ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1235
Practice Address - Country:US
Practice Address - Phone:603-626-9500
Practice Address - Fax:833-448-1486
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH057014-23207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine