Provider Demographics
NPI:1760814081
Name:RUCIENSKI, AMANDA LEE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LEE
Last Name:RUCIENSKI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:378 W CHESTNUT ST STE 103
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4661
Mailing Address - Country:US
Mailing Address - Phone:412-660-7064
Mailing Address - Fax:
Practice Address - Street 1:4229 BARDSTOWN RD STE 218
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3266
Practice Address - Country:US
Practice Address - Phone:502-749-7008
Practice Address - Fax:502-749-7012
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013812363L00000X
IN28255373A363LF0000X
PASP013267363LF0000X
OHAPRN.CNP.026313363LF0000X
WV123636363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner