Individual
AMANDA JO HARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
930 MEZZANINE DR, LAFAYETTE, IN 47905-8631
(765) 607-6160
Mailing address
60 N RICKOVER CIR, LAFAYETTE, IN 47909-4045
(765) 421-1122
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28259877A
IN
363LP0200X
Pediatric Nurse Practitioner
71015603A
IN
Other
Enumeration date
09/25/2023
Last updated
08/06/2024
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