Individual
AMANDA DUDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-2345
Mailing address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-2345
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
215127
SC
363LF0000X
Family Nurse Practitioner
Primary
71015825A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25977
SOUTH CAROLINA BON
SC
05
—
300099802
—
IN
01
—
71015825A
INDIANA BON
IN
Enumeration date
02/28/2022
Last updated
05/16/2025
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