Provider Demographics
NPI:1285516757
Name:IVOS, AMANDA LEE (DNP, FNP-BC, RN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:IVOS
Suffix:
Gender:F
Credentials:DNP, FNP-BC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:155 US HIGHWAY 46 STE 300
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-6836
Mailing Address - Country:US
Mailing Address - Phone:862-666-9285
Mailing Address - Fax:862-666-9287
Practice Address - Street 1:155 US HIGHWAY 46 STE 300
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-6836
Practice Address - Country:US
Practice Address - Phone:862-666-9285
Practice Address - Fax:862-666-9287
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15363900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily