Provider Demographics
NPI:1083932792
Name:BOOKWALTER, AMY SUE (CD(DONA), LCCE)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:SUE
Last Name:BOOKWALTER
Suffix:
Gender:F
Credentials:CD(DONA), LCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9206 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4320
Mailing Address - Country:US
Mailing Address - Phone:703-597-4742
Mailing Address - Fax:
Practice Address - Street 1:9206 PARK AVE
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4320
Practice Address - Country:US
Practice Address - Phone:703-597-4742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula