Provider Demographics
NPI:1154398469
Name:ANKROM, AMY LYNN (CRNP MSN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:ANKROM
Suffix:
Gender:F
Credentials:CRNP MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:180 FORT COUCH RD
Mailing Address - Street 2:STE 304
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1041
Mailing Address - Country:US
Mailing Address - Phone:412-831-0355
Mailing Address - Fax:412-854-5152
Practice Address - Street 1:180 FORT COUCH RD
Practice Address - Street 2:STE 304
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1041
Practice Address - Country:US
Practice Address - Phone:412-831-0355
Practice Address - Fax:412-854-5152
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN510749L163W00000X
PASP007532363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q00486Medicare UPIN
PA074415LNAMedicare ID - Type Unspecified