Individual
AMY ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
255 FRONT ST, HELLERTOWN, PA 18055-1780
(484) 526-5255
(610) 838-6285
Mailing address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(484) 526-6048
(484) 526-6500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP016823
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
664364
MEDICARE GROUP
PA
Enumeration date
11/10/2016
Last updated
11/16/2016
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