Individual
AMY VAN DE WIELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
303 S NAPPANEE ST, ELKHART, IN 46514-2066
(574) 296-3200
Mailing address
PO BOX 39491, BELFAST, ME 04915-1248
(574) 296-3200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71012888A
IN
Other
Enumeration date
07/07/2022
Last updated
09/25/2025
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