Cancilla, Amanda Gordon

Cancilla, Amanda Gordon is an individual health care provider with primary practice located at 225 Baldwin Ave , Charlotte NC 28204-3109. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Cancilla, Amanda Gordon can be contacted via phone (704) 376-1605.

Contact Information

Primary practice address
225 Baldwin Ave Charlotte NC 28204-3109
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 005001127 North Carolina

Profile Details

NPI number 1144289000
LBN Legal business name Cancilla, Amanda Gordon
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated Sep 17th, 2020 - about 4 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.

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