Provider Demographics
NPI:1154743458
Name:LEVINSON, AMY LYNN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:BECHTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2300 COMPUTER RD STE A8
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1733
Mailing Address - Country:US
Mailing Address - Phone:215-390-1449
Mailing Address - Fax:215-345-4749
Practice Address - Street 1:2300 COMPUTER RD STE A8
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1733
Practice Address - Country:US
Practice Address - Phone:215-390-1449
Practice Address - Fax:215-390-1451
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASPO13444363L00000X
PARN637849363L00000X
PASP013444363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA12738152OtherCAQH
PA1154743458OtherNPI
PARN637849OtherRN LICENSE PA
PASPO13444OtherCRNP LICENSE