Healthcare Provider Details

I. General information

NPI: 1477855849
Provider Name (Legal Business Name): ELIZABETH A AMOS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2010
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 N WATER ST
LANCASTER PA
17603-3374
US

IV. Provider business mailing address

304 N WATER ST
LANCASTER PA
17603-3374
US

V. Phone/Fax

Practice location:
  • Phone: 717-299-6371
  • Fax: 717-945-1597
Mailing address:
  • Phone: 717-299-6371
  • Fax: 717-945-1587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP013312
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: