Individual
AMBER R. DEGITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-8686
(260) 436-8585
Mailing address
PO BOX 2526, FORT WAYNE, IN 46801-2526
(260) 436-8686
(260) 436-8585
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71004359A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000807103
ANTHEM
—
05
—
201161790
—
IN
01
—
P01326889
RAILROAD MEDICARE
—
Enumeration date
03/14/2013
Last updated
11/07/2016
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