Provider Demographics
NPI:1023591534
Name:SANTALUCIA, AMY KATHRYN (CRNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:KATHRYN
Last Name:SANTALUCIA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17102-2715
Mailing Address - Country:US
Mailing Address - Phone:171-730-4984
Mailing Address - Fax:
Practice Address - Street 1:728 S BEAVER ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-2209
Practice Address - Country:US
Practice Address - Phone:800-230-7526
Practice Address - Fax:610-481-0486
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019097363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily