Provider Demographics
NPI:1336317346
Name:HENDRIX, AMY LEE (NP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEE
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1436
Mailing Address - Country:US
Mailing Address - Phone:610-750-7891
Mailing Address - Fax:610-750-7896
Practice Address - Street 1:3317 PENN AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19609
Practice Address - Country:US
Practice Address - Phone:610-750-7891
Practice Address - Fax:610-750-7896
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009607363L00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA150588OtherMEDICARE RDA
PASP009607OtherNP LICENSE NUMBER
PA1942442553OtherNPI RDA
PAP00600345OtherRAILROAD MEDICARE PTAN SIEGEL
PADP7691OtherRAILROAD MEDICARE RDA
PA120951XF4Medicare PIN
PAP00600345OtherRAILROAD MEDICARE PTAN SIEGEL