Provider Demographics
NPI:1205156437
Name:LYNCH, AMY A (RN, CLE, CCCE, CLD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:A
Last Name:LYNCH
Suffix:
Gender:F
Credentials:RN, CLE, CCCE, CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 E HILL RD
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-5210
Mailing Address - Country:US
Mailing Address - Phone:303-709-3574
Mailing Address - Fax:
Practice Address - Street 1:680 E HILL RD
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-5210
Practice Address - Country:US
Practice Address - Phone:303-709-3574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2013-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
NY652358163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No374J00000XNursing Service Related ProvidersDoula