Provider Demographics
NPI:1942516638
Name:HATLEY, AMY LYNNE (CPNP-AC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNNE
Last Name:HATLEY
Suffix:
Gender:F
Credentials:CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:846 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-2606
Mailing Address - Country:US
Mailing Address - Phone:202-421-1093
Mailing Address - Fax:
Practice Address - Street 1:4401 PENN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1334
Practice Address - Country:US
Practice Address - Phone:202-421-1093
Practice Address - Fax:124-692-5313
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC195980363LP0200X
PASP012054363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics