Provider Demographics
NPI:1346216181
Name:PEASE, AMY G (RN)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:G
Last Name:PEASE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY CREEK
Mailing Address - State:NY
Mailing Address - Zip Code:14723-9779
Mailing Address - Country:US
Mailing Address - Phone:716-485-6364
Mailing Address - Fax:
Practice Address - Street 1:525 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:CHERRY CREEK
Practice Address - State:NY
Practice Address - Zip Code:14723-9779
Practice Address - Country:US
Practice Address - Phone:716-485-6364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY499586163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse