National Provider Identifier
Amanda Agnes Irvine, NP
Amanda Agnes Irvine, NP is listed in the NPPES registry with a primary specialty of Pediatric Nurse Practitioner in Rochester, NY and a listed phone number of (585) 922-2575.
Profile Overview
- NPI
- 1134774003
- Provider Type
- Individual
- Primary Specialty
- Pediatric Nurse Practitioner
- Enumeration Date
- August 07, 2019
- Last Updated
- August 14, 2020
Practice Location
- 1455 E Ridge RD
- Rochester, NY 14621-2006
Phone: (585) 922-2575
Mailing Address
- 100 Kings Hwy S
- Rochester, NY 14617-5504
Specialties
- Pediatric Nurse Practitioner (363LP0200X)
Full Record
- NPI
- 1134774003
- Entity Type
- Individual
- Last Name
- Irvine
- First Name
- Amanda
- Middle Name
- Agnes
- Credential
- NP
- Provider Other Last Name
- Taillon
- Provider Other First Name
- Amanda
- Provider Other Middle Name
- Agnes
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 100 Kings Hwy S
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14617-5504
- Mailing Country
- US
- Mailing Phone
- (585) 922-2575
- Mailing Fax
- (585) 922-5033
- Practice Street Address
- 1455 E Ridge RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621-2006
- Practice Country
- US
- Practice Phone
- (585) 922-2575
- Practice Fax
- (585) 922-5033
- Enumeration Date
- August 07, 2019
- Last Updated
- August 14, 2020
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- August 14, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatric Nurse Practitioner (363LP0200X)