Provider Demographics
NPI:1922311166
Name:DAVISON, AMY LYNN (RN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:DAVISON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:LASKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2757 LEECHBURG RD
Mailing Address - Street 2:
Mailing Address - City:LOWER BURRELL
Mailing Address - State:PA
Mailing Address - Zip Code:15068-3138
Mailing Address - Country:US
Mailing Address - Phone:724-337-6522
Mailing Address - Fax:724-337-0630
Practice Address - Street 1:2757 LEECHBURG RD
Practice Address - Street 2:
Practice Address - City:LOWER BURRELL
Practice Address - State:PA
Practice Address - Zip Code:15068-3138
Practice Address - Country:US
Practice Address - Phone:724-337-6522
Practice Address - Fax:724-337-0630
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN526597L163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health