Provider Demographics
NPI:1316155567
Name:BARTH, AMY GRAHAM (CRNP)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:GRAHAM
Last Name:BARTH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:S
Other - Last Name:BARTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2373 BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-6000
Mailing Address - Country:US
Mailing Address - Phone:215-752-1810
Mailing Address - Fax:215-752-1060
Practice Address - Street 1:2373 BRISTOL RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-6000
Practice Address - Country:US
Practice Address - Phone:215-752-1810
Practice Address - Fax:215-752-1060
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008584363LF0000X
PASP 008584363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily