Provider Demographics
NPI:1811641434
Name:FOGELSANGER, AMY (LPN, CD(DONA), PPD)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:FOGELSANGER
Suffix:
Gender:F
Credentials:LPN, CD(DONA), PPD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:WILT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN, CD(DONA), PPD
Mailing Address - Street 1:7260 SANDY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-9302
Mailing Address - Country:US
Mailing Address - Phone:717-329-6479
Mailing Address - Fax:
Practice Address - Street 1:7260 SANDY HOLLOW RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-9302
Practice Address - Country:US
Practice Address - Phone:717-329-6479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174N00000X, 374J00000X
PAPN278964164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No164W00000XNursing Service ProvidersLicensed Practical Nurse