Provider Demographics
NPI:1871882092
Name:WOODLEY, AMANDA M (RN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:WOODLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 STONY BATTERY RD
Mailing Address - Street 2:
Mailing Address - City:LANDISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17538-1028
Mailing Address - Country:US
Mailing Address - Phone:717-459-3335
Mailing Address - Fax:
Practice Address - Street 1:1808 COLONIAL VILLAGE LN
Practice Address - Street 2:SUITE 103
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6745
Practice Address - Country:US
Practice Address - Phone:717-391-0172
Practice Address - Fax:717-391-7771
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN606864163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse