Provider Demographics
NPI:1831536705
Name:WERT, AMANDA CAROL (CRNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:CAROL
Last Name:WERT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CAROL
Other - Last Name:KATCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2106 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-291-5931
Mailing Address - Fax:717-735-7119
Practice Address - Street 1:2106 HARRISBURG PIKE
Practice Address - Street 2:SUITE 1
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-291-5931
Practice Address - Fax:717-735-7119
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012891363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50117314OtherCAPITAL BLUE CROSS
PA102844403Medicaid
PA295147YZC0Medicare PIN