1154743458 NPI number — MRS. AMY LYNN LEVINSON FNP-BC

Table of content: MRS. AMY LYNN LEVINSON FNP-BC (NPI 1154743458)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154743458 NPI number — MRS. AMY LYNN LEVINSON FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEVINSON
Provider First Name:
AMY
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BECHTEL
Provider Other First Name:
AMY
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1154743458
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2300 COMPUTER RD STE A8
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLOW GROVE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19090-1733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-390-1449
Provider Business Mailing Address Fax Number:
215-345-4749

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2300 COMPUTER RD STE A8
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLOW GROVE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19090-1733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-390-1449
Provider Business Practice Location Address Fax Number:
215-390-1451
Provider Enumeration Date:
01/06/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  SPO13444 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: RN637849 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: SP013444 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 12738152 . This is a "CAQH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1154743458 . This is a "NPI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: RN637849 . This is a "RN LICENSE PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: SPO13444 . This is a "CRNP LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".