Provider Demographics
NPI:1770674020
Name:BINCK, AMY I (APN)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:I
Last Name:BINCK
Suffix:
Gender:F
Credentials:APN
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Other - Credentials:
Mailing Address - Street 1:7777 HENNESSY BLVD SUITE 103
Mailing Address - Street 2:PEDIATRIC HOSPITALISTS OF LA
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808
Mailing Address - Country:US
Mailing Address - Phone:225-767-6700
Mailing Address - Fax:225-767-6721
Practice Address - Street 1:7777 HENNESSY BLVD SUITE 103
Practice Address - Street 2:PEDIATRIC HOSPITALISTS OF LA
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808
Practice Address - Country:US
Practice Address - Phone:225-767-6700
Practice Address - Fax:225-767-6721
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAAP06000363LP0200X, 363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2155083Medicaid
NJ0082899Medicaid
018475A34Medicare PIN
MD4092376Medicaid