Individual
AMY A NICLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1329 W 96TH ST STE 1, INDIANAPOLIS, IN 46260-1190
(317) 660-0888
(317) 660-0880
Mailing address
1329 W 96TH ST STE 1, INDIANAPOLIS, IN 46260-1190
(317) 660-0888
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002230A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201094870
—
IN
Enumeration date
11/07/2006
Last updated
12/09/2016
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