AMANDA JANE REILLY APRN NPI 1417231895

NPI Information

NPI: 1417231895
Provider Name: AMANDA JANE REILLY, APRN
Classification: Registered Nurse - 163WP0809X
Entity Type: Individual

Specialization: Psychiatric/Mental Health, Adult

PECOS Registration: Yes

Address:
57 SACHEMUS TRL
BREWSTER, MA
ZIP 02631
Phone: (413) 210-5352
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Amanda Jane Reilly, APRN is a psychiatric/mental health and adult registered nurse in Brewster, MA. Amanda Jane Reilly, APRN NPI is 1417231895. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

57 SACHEMUS TRL
BREWSTER, MA
ZIP 02631-080
Phone: (413) 210-5352

The NPI 1417231895 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/4/2011 and was last updated on 4/13/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WP0807X	Registered Nurse	Psychiatric/Mental Health, Child & Adolescent	RN2265481	MASSACHUSETTS	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	APRN #004703	CONNECTICUT	No
3	163WP0809X	Registered Nurse	Psychiatric/Mental Health, Adult	RN2265481	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1417231895	MEDICAID	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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