Healthcare Provider Details

I. General information

NPI: 1154610434
Provider Name (Legal Business Name): AMY LOPEZ RHOADES NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 10/18/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 N 7TH ST
CHAMBERSBURG PA
17201-1720
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-851-2613
  • Fax: 717-851-2602
Mailing address:
  • Phone: 717-851-2613
  • Fax: 717-851-2602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberSP024567
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberRN115405-AP06437
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: