Provider Demographics
NPI:1699255539
Name:FUCCI, AMANDA J (APRN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:J
Last Name:FUCCI
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 1:27 NEW DURHAM RD
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:NH
Mailing Address - Zip Code:03809-4917
Mailing Address - Country:US
Mailing Address - Phone:603-875-6151
Mailing Address - Fax:
Practice Address - Street 1:27 NEW DURHAM RD
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:NH
Practice Address - Zip Code:03809-4917
Practice Address - Country:US
Practice Address - Phone:603-875-6151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH057371-23363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH057371-23OtherAPRN MEDICAL LICENSE