Individual
MRS. AMY LYNN PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2001 HUTCHINS AVE, SUITE C, BALLINGER, TX 76821-4452
(325) 365-5737
(325) 365-2405
Mailing address
PO BOX 617, BALLINGER, TX 76821-0617
(325) 365-5737
(325) 365-2405
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA03906
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
342315401
—
TX
01
—
TXB159266
MEDICARE PTAN
TX
Enumeration date
06/14/2006
Last updated
07/19/2016
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