Individual provider Active NPI

Amanda Lynn Eissing, RN

  • Registered Nurse
  • Ravena, NY
National Provider Identifier
1235939844
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
818185 Issued in NY
Practice address
15 Mountain Rd
Ravena, NY 12143-1235
Phone
(518) 756-5200
NPI assigned
Mar 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 818185 NY Primary

Addresses

Primary practice location

15 Mountain Rd
Ravena, NY 12143-1235

Mailing address

PO Box 158
Ravena, NY 12143-0158
Phone (518) 265-9353

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
818185NYMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1235939844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "RAVENA",
            "state": "NY",
            "postal_code": "121430158",
            "telephone_number": "518-265-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MOUNTAIN RD",
            "city": "RAVENA",
            "state": "NY",
            "postal_code": "121431235",
            "telephone_number": "518-756-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISSING",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "818185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravena, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.