Individual
AMY ELIZABETH SPEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5177 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8100
(765) 446-7088
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003935A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
815500562
MEDICARE PTAN
IN
Enumeration date
01/03/2023
Last updated
06/08/2023
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