Provider Demographics
NPI:1740549427
Name:BRICKNER, AMY JILL (CRNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:JILL
Last Name:BRICKNER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:STRAHLER
Other - Last Name:BRICKNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-6110
Mailing Address - Fax:717-741-1076
Practice Address - Street 1:300 PINE GROVE CMNS
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5176
Practice Address - Country:US
Practice Address - Phone:717-851-6110
Practice Address - Fax:717-741-1076
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012101363L00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2702253OtherHIGHMARK BLUE SHIELD-FREEDOM BLUE
PA239803FLTMedicare PIN
PA239803Medicare PIN