Individual
AMBER FAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1664 W SMITH VALLEY RD, GREENWOOD, IN 46142-1550
(317) 887-7640
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28159374A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201313060
—
IN
Enumeration date
01/26/2015
Last updated
11/27/2023
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