Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amy Landis Formyduval

Individual provider Certified Registered Nurse Anesthetist · NPI 1588033450

Amy Landis Formyduval is a Certified Registered Nurse Anesthetist (CRNA) in Wilmington, North Carolina. Qualified in 2015, 11 years ago. Practices with Novant Health New Hanover Regional Medical Center LLC, a 197-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
11
Licensed in
NC
In the registry since
2015
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Practice location Address checks out

6404 Spicewood St
Wilmington, NC 28405-7756
Phone: (910) 840-6802
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 203176 (NC)

Record details

NPI number1588033450
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 21, 2015
Last updated in NPPESMarch 17, 2021
Certification dateMarch 17, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Novant Health New Hanover Regional Medical Center Llc — 197 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Wilmington