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General NPI Number Information
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NPI Number | 1760814081
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Entity Type | Individual
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Provider Name | AMANDA LEE RUCIENSKI NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 08/09/2013
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 4229 BARDSTOWN RD STE 218
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City | LOUISVILLE
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State | KY
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Zip | 40218-3266
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Country | US
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Telephone | 502-749-7008
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Fax | 502-749-7012
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Provider Business Mailing Address
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Address Line | 378 W CHESTNUT ST STE 103
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City | WASHINGTON
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State | PA
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Zip | 15301-4661
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Country | US
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Telephone | 412-660-7064
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3013812
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28255373A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP013267
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.026313
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 123636
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License Number State | WV
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