Provider Demographics
NPI:1326358953
Name:HUANG, AMY (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 N BROAD ST FL 7
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1500
Mailing Address - Country:US
Mailing Address - Phone:215-568-0860
Mailing Address - Fax:215-568-7261
Practice Address - Street 1:112 N BROAD ST FL 7
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1500
Practice Address - Country:US
Practice Address - Phone:215-568-0860
Practice Address - Fax:215-568-7261
Is Sole Proprietor?:No
Enumeration Date:2010-10-17
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN518738L164W00000X
PASP010865363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse