Provider Demographics
NPI:1689041733
Name:HOETZEL, AMY JOELLE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:JOELLE
Last Name:HOETZEL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:JOELLE
Other - Last Name:HOLSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:607 DUTCHMANS LN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3345
Mailing Address - Country:US
Mailing Address - Phone:410-822-9133
Mailing Address - Fax:
Practice Address - Street 1:607 DUTCHMANS LN
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3345
Practice Address - Country:US
Practice Address - Phone:410-822-9133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR176385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily