# AMY FORSYTHE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1598865537
- **Gender:** F
- **Credential:** N.P.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0200X | Pediatric Nurse Practitioner | R857964 | MS | Yes |

## Other

- **Enumeration date:** 09/22/2006
- **Last updated:** 06/14/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 07628011 | — | MS |
| 05 | — | 1722189 | — | LA |
| 01 | — | 302I509755 | MEDICARE PTAN | MS |