Provider Demographics
NPI:1962002634
Name:CESSNA, AMY R (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:R
Last Name:CESSNA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14302 BARTON BLVD SW
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-5852
Mailing Address - Country:US
Mailing Address - Phone:301-729-3278
Mailing Address - Fax:301-729-8702
Practice Address - Street 1:14302 BARTON BLVD SW
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-5852
Practice Address - Country:US
Practice Address - Phone:301-729-3278
Practice Address - Fax:301-729-8702
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR173346363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner