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General NPI Number Information
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NPI Number | 1639631096
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Entity Type | Individual
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Provider Name | AMANDA RENEE KENDIG CRNP
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Gender | Female
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 300 MAYTOWN RD
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City | ELIZABETHTOWN
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State | PA
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Zip | 17022-9314
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Country | US
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Telephone | 717-367-1430
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Fax | 717-367-2895
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Provider Business Mailing Address
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Address Line | 8130 ADAMS DR
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City | HUMMELSTOWN
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State | PA
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Zip | 17036-8623
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Country | US
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Telephone | 717-967-8288
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Fax | 717-967-8291
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN715836
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NPPA037589
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP020363
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP032584
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License Number State | PA
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