Individual
AMANDA ULICNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
587 WADE RD, SAINT CLAIR, PA 17970-1158
(570) 640-3022
Mailing address
587 WADE RD, SAINT CLAIR, PA 17970-1158
(570) 640-3022
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN276467
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN276467
LPN
—
Enumeration date
08/09/2016
Last updated
08/09/2016
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