Individual
AMY L LICATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
301 S 7TH AVE, SUITE 2020, WEST READING, PA 19611-1410
(610) 375-6565
(610) 375-2065
Mailing address
PO BOX 13579, READING, PA 19612-3579
(484) 628-0796
(484) 334-7026
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP-007431
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103102437
—
PA
Enumeration date
04/05/2006
Last updated
08/19/2016
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