Provider Demographics
NPI:1285325696
Name:DANGLE, AMANDA LEE (CRNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:DANGLE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LEE
Other - Last Name:HINKAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:255 US HIGHWAY 220
Mailing Address - Street 2:
Mailing Address - City:MUNCY
Mailing Address - State:PA
Mailing Address - Zip Code:17756-6561
Mailing Address - Country:US
Mailing Address - Phone:570-368-2870
Mailing Address - Fax:
Practice Address - Street 1:255 US HIGHWAY 220
Practice Address - Street 2:
Practice Address - City:MUNCY
Practice Address - State:PA
Practice Address - Zip Code:17756-6561
Practice Address - Country:US
Practice Address - Phone:570-368-2870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027516363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner