Provider Demographics
NPI:1225920358
Name:HERTZ, AMY
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HERTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2932 ARMSTRONG ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ND
Mailing Address - Zip Code:58504-9019
Mailing Address - Country:US
Mailing Address - Phone:701-426-8346
Mailing Address - Fax:
Practice Address - Street 1:306 15TH ST NW APT 8
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-2081
Practice Address - Country:US
Practice Address - Phone:701-425-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker