Provider Demographics
NPI:1396337317
Name:WESTIN, AMY
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:WESTIN
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 1:1028 AZTEC DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25405-7195
Mailing Address - Country:US
Mailing Address - Phone:240-520-7752
Mailing Address - Fax:
Practice Address - Street 1:1028 AZTEC DR
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25405-7195
Practice Address - Country:US
Practice Address - Phone:240-520-7752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker