Provider Demographics
NPI:1477824217
Name:PENCE, AMY JO (CRNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JO
Last Name:PENCE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1591 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3224
Mailing Address - Country:US
Mailing Address - Phone:610-326-8005
Mailing Address - Fax:610-327-9629
Practice Address - Street 1:307 S LEWIS RD
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-1828
Practice Address - Country:US
Practice Address - Phone:610-792-0300
Practice Address - Fax:610-792-3790
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP011879363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily