Tibert, Amanda Mae
Tibert, Amanda Mae is an sole proprietor health care provider with primary practice located at 83 Herrick St Ste 2004 , Beverly MA 01915-2757. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Tibert, Amanda Mae can be contacted via phone (978) 927-4800.Contact Information
Primary practice address
83 Herrick St Ste 2004
Beverly MA 01915-2757
Phone: (978) 927-4800
Fax: (978) 777-4792
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA7714 | Massachusetts |
Profile Details
| NPI number | 1639781230 |
|---|---|
| LBN Legal business name | Tibert, Amanda Mae |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 17th, 2020 |
| Last updated | Dec 29th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639781230 | NPPES |
| Massachusetts | Other | 1173579 | NCCPA CERTIFICATION |
| Massachusetts | Other | PA7714 | NCCPA CERTIFICATION |
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