Provider Demographics
NPI:1518626415
Name:LAW, AMY LANA (LVN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LANA
Last Name:LAW
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24625 ARCH ST
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-1111
Mailing Address - Country:US
Mailing Address - Phone:818-779-0555
Mailing Address - Fax:
Practice Address - Street 1:24625 ARCH ST
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-1111
Practice Address - Country:US
Practice Address - Phone:818-779-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN274787164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse