Provider Demographics
NPI:1073835237
Name:CLINE, AMY J
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:CLINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49131 BATESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43788-9704
Mailing Address - Country:US
Mailing Address - Phone:740-838-4301
Mailing Address - Fax:
Practice Address - Street 1:49131 BATESVILLE RD
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:OH
Practice Address - Zip Code:43788-9704
Practice Address - Country:US
Practice Address - Phone:740-838-4301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN101498164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse