Provider Demographics
NPI:1457591133
Name:BOSTAPH, AMY L (CRNA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:BOSTAPH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:SCHOENHUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:3100 SPRING FOREST ROAD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2880
Mailing Address - Country:US
Mailing Address - Phone:919-882-0705
Mailing Address - Fax:919-873-9821
Practice Address - Street 1:5801 BREMO ROAD
Practice Address - Street 2:AMERICAN ANESTHESIOLOGY OF VIRGINIA, PC
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1907
Practice Address - Country:US
Practice Address - Phone:804-288-6258
Practice Address - Fax:804-282-9921
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168199367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered