| Doctor Name: | MISS AMANDA WALDHEIM CARLSON |
| NPI Number: | 1023077674 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NNP |
| License Number: | 54483 |
| Business Practice Address: | 455 Toll Gate Rd Warwick, RI - 028862759 |
| Business Phone Number: | 4012741122 |
| Business Fax Number: | |
| Mailing Address: | 3 Berkeley Ter, NEWPORT |
| State: | RI |
| Postal Code: | 028403503 |
| Phone Number: | 4152656967 |
| Fax Number: | |
| NPI Enumeration Date: | 03/22/2006 |
| NPI Last Update Date: | 07/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WN0002X |
| License Number: | 54483 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Neonatal Intensive Care |
| Taxonomy Definition: | |