Provider Demographics
NPI:1992246532
Name:DOSSEY, AMANDA (LPN)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:
Last Name:DOSSEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 OLIVE CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11738-1924
Mailing Address - Country:US
Mailing Address - Phone:631-355-5173
Mailing Address - Fax:
Practice Address - Street 1:12 OLIVE CT
Practice Address - Street 2:
Practice Address - City:FARMINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:11738-1924
Practice Address - Country:US
Practice Address - Phone:631-355-5173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303631164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse