Provider Demographics
NPI:1134434947
Name:KINATEDER, AMY PATRICE (RN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:PATRICE
Last Name:KINATEDER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-1823
Mailing Address - Country:US
Mailing Address - Phone:215-276-5500
Mailing Address - Fax:
Practice Address - Street 1:260 S BROAD ST
Practice Address - Street 2:18TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-5021
Practice Address - Country:US
Practice Address - Phone:215-985-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN612982163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse