Provider Demographics
NPI:1528729621
Name:ABRAMS, AMANDA (NP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:ABRAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 41994
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22404-1994
Mailing Address - Country:US
Mailing Address - Phone:540-734-9423
Mailing Address - Fax:202-951-4217
Practice Address - Street 1:3102 PLANK ROAD
Practice Address - Street 2:# 41994
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22404-1614
Practice Address - Country:US
Practice Address - Phone:540-734-9423
Practice Address - Fax:202-951-4217
Is Sole Proprietor?:No
Enumeration Date:2022-01-01
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAB202300653146N00000X
VA0001263443163W00000X
171000000X
VA0024181072363L00000X, 363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No163W00000XNursing Service ProvidersRegistered Nurse
No171000000XOther Service ProvidersMilitary Health Care Provider
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1386750420Medicaid