Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | SP013057 | PA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | SP013057 | PA |
NPI | 1003249079 |
---|---|
Provider Name | Ms. Amanda Elizabeth Hershey |
First Address | Harrisburg, PA 17104-1612 |
Second Address | Mechanicsburg, PA 17050-9413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2013 |
Last Update Date | 09/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103093445 | (05) | PA |