Individual
AMY L RAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260
(317) 338-2121
Mailing address
6625 LOWANNA WAY, INDIANAPOLIS, IN 46220-4364
(513) 846-0521
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
—
—
363A00000X
Physician Assistant
50.002797
OH
363AM0700X
Medical Physician Assistant
Primary
10000888A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000947608
ANTHEM PIN
IN
01
—
037870016
MEDICARE ST. VINCENT
IN
Enumeration date
07/25/2006
Last updated
05/25/2018
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