Provider Demographics
NPI:1518363985
Name:WINEHOLT, AMANDA N (LPN)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:N
Last Name:WINEHOLT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E KING ST
Mailing Address - Street 2:
Mailing Address - City:DALLASTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17313-1812
Mailing Address - Country:US
Mailing Address - Phone:717-779-8411
Mailing Address - Fax:
Practice Address - Street 1:2250 HICKORY ROAD, SUITE 240
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462
Practice Address - Country:US
Practice Address - Phone:888-701-2089
Practice Address - Fax:610-825-1604
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN285885164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPN285885OtherLPN LICENSE NUMBER