Provider Demographics
NPI:1073840518
Name:ROMEIS, AMANDA CANDACE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:CANDACE
Last Name:ROMEIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CANDACE
Other - Last Name:EBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32 SCOTT CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14546-1209
Mailing Address - Country:US
Mailing Address - Phone:585-889-0009
Mailing Address - Fax:
Practice Address - Street 1:32 SCOTT CRESCENT DR
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14546-1209
Practice Address - Country:US
Practice Address - Phone:585-889-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288963-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse