Provider Demographics
NPI:1689005605
Name:WESTLAND, AMY LEIGH
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEIGH
Last Name:WESTLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5265 S 110TH ST
Mailing Address - Street 2:
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-1201
Mailing Address - Country:US
Mailing Address - Phone:414-708-4659
Mailing Address - Fax:
Practice Address - Street 1:5265 S 110TH ST
Practice Address - Street 2:
Practice Address - City:HALES CORNERS
Practice Address - State:WI
Practice Address - Zip Code:53130-1201
Practice Address - Country:US
Practice Address - Phone:414-708-4659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI168540-30163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics