Provider Demographics
NPI:1629114574
Name:WOODCHEKE, AMY LIN (BS, MHS, PA-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LIN
Last Name:WOODCHEKE
Suffix:
Gender:F
Credentials:BS, MHS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 MAPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1526
Mailing Address - Country:US
Mailing Address - Phone:302-368-8612
Mailing Address - Fax:
Practice Address - Street 1:735 MAPLETON AVE, SUITE 100
Practice Address - Street 2:CCHS PEDIATRIC ASSOCIATES AT WHITEHALL
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709
Practice Address - Country:US
Practice Address - Phone:302-368-8612
Practice Address - Fax:302-203-2424
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003342363A00000X
DEC5000704363AM0700X
DEC5-0000704363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant