Provider Demographics
NPI:1326700808
Name:FIELD, AMY (HIS)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:FIELD
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 COLONIAL AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-3204
Mailing Address - Country:US
Mailing Address - Phone:540-343-0165
Mailing Address - Fax:540-345-4664
Practice Address - Street 1:2030 COLONIAL AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24015-3204
Practice Address - Country:US
Practice Address - Phone:540-343-0165
Practice Address - Fax:540-345-4664
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3460237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2101002897OtherHIS
IL3460OtherHID