Healthcare Provider Details

I. General information

NPI: 1669336574
Provider Name (Legal Business Name): AMAYA S PHELPS STNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 RENTAR LN APT 602
AKRON OH
44307-1452
US

IV. Provider business mailing address

1180 RENTAR LN APT 602
AKRON OH
44307-1452
US

V. Phone/Fax

Practice location:
  • Phone: 234-281-9168
  • Fax:
Mailing address:
  • Phone: 234-281-9168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number602856470724
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: