Basic Information
| Provider Information | |||||||||
| NPI: | 1356349997 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LENDLER | ||||||||
| FirstName: | AMANDA | ||||||||
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| Credential: | CNM; MSN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 COLUMBUS AVE | ||||||||
| Address2: | CREDENTIALING SPECIALIST | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065191233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035033174 | ||||||||
| FaxNumber: | 2035033183 | ||||||||
| Practice Location | |||||||||
| Address1: | 675 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CHESHIRE | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064103153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032502125 | ||||||||
| FaxNumber: | 2032502161 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2005 | ||||||||
| LastUpdateDate: | 12/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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| NPICertificationDate: | 12/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 00206 LNM | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 707789 | 01 | CONNECTICARE | OTHER | 40CNM0206CT01 | 01 | CT | ANTHIM BLUE CROSS OF CT | OTHER | 0Q2712 | 01 | HEALTH NET | OTHER | P2854778 | 01 | OXFORD HEALTH PLANS | OTHER |