Healthcare Provider Details

I. General information

NPI: 1215248133
Provider Name (Legal Business Name): AMANDA ESCH FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 07/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 W. MAIN ST. #175
NEW ALBANY OH
43054
US

IV. Provider business mailing address

620 HUBER DR
HEATH OH
43056-1791
US

V. Phone/Fax

Practice location:
  • Phone: 614-284-4114
  • Fax: 614-245-4389
Mailing address:
  • Phone: 740-975-3812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA. 11371-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: