Provider Demographics
NPI:1962992792
Name:PRICE, AMI LYNN (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:AMI
Middle Name:LYNN
Last Name:PRICE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-3507
Mailing Address - Country:US
Mailing Address - Phone:570-808-8921
Mailing Address - Fax:570-808-8926
Practice Address - Street 1:25 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-3507
Practice Address - Country:US
Practice Address - Phone:570-808-8921
Practice Address - Fax:570-808-8926
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN520523L163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory