Provider Demographics
NPI:1265842124
Name:EDGAR, AMY (APRN, CRNP, FNP-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:EDGAR
Suffix:
Gender:F
Credentials:APRN, CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2057 TUMBLEBROOK RD
Mailing Address - Street 2:
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-2206
Mailing Address - Country:US
Mailing Address - Phone:610-282-8072
Mailing Address - Fax:
Practice Address - Street 1:1247 S CEDAR CREST BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6298
Practice Address - Country:US
Practice Address - Phone:610-770-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013766363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily