Provider Demographics
NPI:1134538937
Name:PLETZ, AMANDA L (CRNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:PLETZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 RIVERVIEW RD
Mailing Address - Street 2:PO BOX 101
Mailing Address - City:CLARKSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15725-8936
Mailing Address - Country:US
Mailing Address - Phone:724-422-7915
Mailing Address - Fax:
Practice Address - Street 1:5703 STEUBENVILLE PIKE
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1310
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014018363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily