Provider Demographics
NPI:1053668848
Name:WOZNICKI, AMY (CP, CFO)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:WOZNICKI
Suffix:
Gender:F
Credentials:CP, CFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4702 CREEKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8410
Mailing Address - Country:US
Mailing Address - Phone:919-797-1230
Mailing Address - Fax:919-797-1240
Practice Address - Street 1:4702 CREEKSTONE DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-8410
Practice Address - Country:US
Practice Address - Phone:919-797-1230
Practice Address - Fax:919-797-1240
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECPO03473222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist