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Amanda Stackhouse

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

254 Easton Ave, New Brunswick, NJ 08901-1766

PECOS Enrollment

Based on the most recent information from CMS, provider Amanda Stackhouse is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1801644505
Provider Type
Individual
Full Name
Stackhouse, Amanda
Credential
APN

Gender
Female
Sole Proprietor
No
Enumeration Date
5/8/2024
Last Updated
5/8/2024

Contact Information

Practice Location

254 Easton Ave, New Brunswick, NJ 08901-1766

(732) 745-8600

Unlisted Fax

Mailing Location

6 Gail Rd, Hillsborough, NJ 08844-4207

(908) 392-4475

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 26NJ15002000 New Jersey

Amanda Stackhouse

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Rosario, Yaritza M

Trinidad, Vincent

Valdez, Adrienne Gail

Gibbons, Geraldine Blaney

Hernandez, Melissa

Pecoraro, Joanne

Goldstein, Diana Rae

Pechera, Jasper

Catalano, Carolyn

Lezark, Melissa