Provider Demographics
NPI:1366156036
Name:NIEMIEC, AMANDA LUCY
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LUCY
Last Name:NIEMIEC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 N JAMESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-1014
Mailing Address - Country:US
Mailing Address - Phone:412-327-6070
Mailing Address - Fax:
Practice Address - Street 1:141 N JAMESTOWN RD
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-1014
Practice Address - Country:US
Practice Address - Phone:412-327-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA735461163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency