Provider Demographics
NPI:1699281212
Name:HYLAND, AMANDA
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:HYLAND
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 1:700 HORIZON CIRCLE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914
Mailing Address - Country:US
Mailing Address - Phone:215-395-8888
Mailing Address - Fax:
Practice Address - Street 1:700 HORIZON CIRCLE
Practice Address - Street 2:SUITE 206
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-1891
Practice Address - Country:US
Practice Address - Phone:215-395-8888
Practice Address - Fax:877-795-7518
Is Sole Proprietor?:No
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA059610363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical