Amanda Petruskevicius, CRNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

SP023747 Issued in PA

Practice address

800 E Lancaster Ave
Villanova, PA 19085-1603

Phone

(610) 519-4500

NPI assigned

Jun 9, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1568039360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 513",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190730513",
            "telephone_number": "484-962-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E LANCASTER AVE",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "190851603",
            "telephone_number": "610-519-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUSKEVICIUS",
        "first_name": "AMANDA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP023747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Agnes Ostick, CRNP
• Viraj Ashish Parikh, PA-C
• Lilly Moss Parllaku, PA-C
• James Monroe Pedigo, MD
• John Peters
• Terry Jay Peura, CRNP
• David Pezzeca, PSY.D.
• Alison Dean Portnoy, M.D.
• Candice N Post, PSYD
• Robin Dale Powell, M.D.

• Primary Care Nurse Practitioner in Villanova, PA
• Providers in Villanova, PA by specialty
• Primary Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.