Amanda Lynch

Individual provider Active NPI Medical-Surgical Registered Nurse · Big Flats, NY

NPI 1104338292 · NPPES record last updated Dec 14, 2019

Key facts

NPI
1104338292
Entity type
Individual (NPI type 1)
Primary specialty
Medical-Surgical Registered Nurse 163WM0705X
License
745481 (NY)
Practice address
12 Orchard Dr
Big Flats, NY 14814-7905
Phone
(607) 215-1295
NPI assigned
Oct 29, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
745481NYMDMedical-Surgical Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 745481 NY Yes

Addresses

Primary practice location

12 Orchard Dr
Big Flats, NY 14814-7905

Mailing address

12 Orchard Dr
Big Flats, NY 14814-7905
Phone (607) 215-1295

Other names

  • Amanda Larson Professional name

Other providers in Big Flats, NY

All providers in Big Flats, NY · Medical-Surgical Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.