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Individual

MANDY CORINNE ALTHOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1373 E STATE ROAD 62 STE 2C, MADISON, IN 47250-7328
(812) 801-0840
(812) 801-0024
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71003745A
IN
363LA2100X
Acute Care Nurse Practitioner
Primary
71003745A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201085400
IN
05
7100314430
KY
Enumeration date
10/13/2011
Last updated
12/08/2025
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