Healthcare Provider Details

I. General information

NPI: 1225950165
Provider Name (Legal Business Name): AMY DAVILA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 CENTER VALLEY PKWY
CENTER VALLEY PA
18034-9519
US

IV. Provider business mailing address

3200 CENTER VALLEY PKWY
CENTER VALLEY PA
18034-9519
US

V. Phone/Fax

Practice location:
  • Phone: 610-242-0345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP034374
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP034374
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: