Individual
AMY M ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
520 S 7TH ST, VINCENNES, IN 47591-1038
(812) 886-6565
(812) 886-6566
Mailing address
1160 E SAINT CLAIR ST, VINCENNES, IN 47591-4853
(812) 885-3106
(812) 885-8499
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28188405A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300027459
—
IN
Enumeration date
03/13/2019
Last updated
03/01/2024
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