Individual
AMANDA MCNICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Contact information
Practice address
420 S 5TH AVE, READING, PA 19611-2143
(484) 628-4879
Mailing address
PO BOX 13579, READING, PA 19612-3579
(484) 628-0799
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP008236
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101428038
—
PA
Enumeration date
11/30/2006
Last updated
04/12/2018
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