Provider Demographics
NPI:1326419367
Name:SMEAL, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SMEAL
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 1:8851 SHILOH RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:PA
Mailing Address - Zip Code:16881-8446
Mailing Address - Country:US
Mailing Address - Phone:484-663-4340
Mailing Address - Fax:814-342-2755
Practice Address - Street 1:1633 PHILIPSBURG BIGLER HWY
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-8112
Practice Address - Country:US
Practice Address - Phone:814-342-5678
Practice Address - Fax:814-342-2755
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN548277163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse