Individual
AMY E. NUGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7900 W JEFFERSON BLVD, SUITE 201, FORT WAYNE, IN 46804-4128
(260) 432-2297
(260) 969-7266
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001373A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000289907
ANTHEM
IN
05
—
200391110
—
IN
05
—
2463874
—
OH
01
—
P00783823
RAILROAD MEDICARE
IN
Enumeration date
03/20/2006
Last updated
09/29/2020
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