Individual
AMY JO MINTZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
700 HIGH ST, WILLIAMSPORT HOSPITAL & MEDICAL CENTER, WILLIAMSPORT, PA 17701-3198
(570) 321-2385
(570) 321-2479
Mailing address
1201 GRAMPIAN BLVD, PO BOX 3127, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN263988L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012634090004
—
PA
05
—
0012634090005
—
PA
05
—
0012634090006
—
PA
01
—
50494
GEISINGER HEALTH PLAN
PA
Enumeration date
06/09/2006
Last updated
01/13/2012
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