National Provider Identifier
Amanda Marie Larson, PMHNP-BC
Amanda Marie Larson, PMHNP-BC is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Nurse Practitioner in Buffalo, NY and a listed phone number of (716) 898-3000.
Profile Overview
- NPI
- 1891568028
- Provider Type
- Individual
- Primary Specialty
- Psychiatric/Mental Health Nurse Practitioner
- Enumeration Date
- October 31, 2023
- Last Updated
- December 03, 2023
Practice Location
- 462 Grider St
- Buffalo, NY 14215-3021
Phone: (716) 898-3000
Specialties
- Psychiatric/Mental Health Nurse Practitioner (363LP0808X)
Full Record
- NPI
- 1891568028
- Entity Type
- Individual
- Last Name
- Larson
- First Name
- Amanda
- Middle Name
- Marie
- Credential
- PMHNP-BC
- Provider Other Last Name
- Maraschiello
- Provider Other First Name
- Amanda
- Provider Other Middle Name
- Marie
- Provider Other Credential Text
- PMHNP-BC
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 462 Grider St
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14215-3021
- Mailing Country
- US
- Practice Street Address
- 462 Grider St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14215-3021
- Practice Country
- US
- Practice Phone
- (716) 898-3000
- Enumeration Date
- October 31, 2023
- Last Updated
- December 03, 2023
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- December 03, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Psychiatric/Mental Health Nurse Practitioner (363LP0808X)