Provider Demographics
NPI:1649507054
Name:WINTERS, AMANDA LEE (RN, HCHI)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LEE
Last Name:WINTERS
Suffix:
Gender:F
Credentials:RN, HCHI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 ROUTE 300
Mailing Address - Street 2:BOX A
Mailing Address - City:WALLKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12589-3930
Mailing Address - Country:US
Mailing Address - Phone:845-851-8082
Mailing Address - Fax:
Practice Address - Street 1:2415 ROUTE 300
Practice Address - Street 2:BOX A
Practice Address - City:WALLKILL
Practice Address - State:NY
Practice Address - Zip Code:12589-3930
Practice Address - Country:US
Practice Address - Phone:845-895-9019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X, 374J00000X
NY545646163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174H00000XOther Service ProvidersHealth Educator
No374J00000XNursing Service Related ProvidersDoula