Provider Demographics
NPI:1801261664
Name:FRANTZ, AMY MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:FRANTZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:HORDENDORF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2500 BERNVILLE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9453
Mailing Address - Country:US
Mailing Address - Phone:610-779-1330
Mailing Address - Fax:610-779-7699
Practice Address - Street 1:3970 PERKIOMEN AVENUE
Practice Address - Street 2:SUITE 102
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-2719
Practice Address - Country:US
Practice Address - Phone:610-779-1330
Practice Address - Fax:610-779-7699
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058004363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA473671Medicare PIN