AMANDA MACKILLOP NP NPI 1770128753

NPI Information

  • NPI: 1770128753
  • Provider Name: AMANDA MACKILLOP, NP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 54655 MAIN RD
    SOUTHOLD, NY
    ZIP 11971
  • Phone: (631) 301-2271

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NPI Details

Amanda Mackillop, NP is a psychiatric/mental health nurse practitioner in Southold, NY with 5 years of experience. Amanda Mackillop, NP NPI is 1770128753. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

54655 MAIN RD
SOUTHOLD, NY
ZIP 11971-769
Phone: (631) 301-2271
Fax: (631) 212-0482

The NPI 1770128753 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 11/13/2019 and was last updated on 12/17/2025.

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
1363LP0808XNurse PractitionerPsychiatric/Mental Health403484NEW YORKYes
2163W00000XRegistered Nurse780342NEW YORKNo

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: 11/21/2025

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