Individual
AMANDA M. TOMIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
705 RILEY HOSPITAL DR, RR 208, INDIANAPOLIS, IN 46202-5109
(317) 274-4715
(317) 274-2065
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 274-1201
(317) 278-9905
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
28198933
IN
363LN0000X
Neonatal Nurse Practitioner
Primary
71003806
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201071210
—
IN
Enumeration date
02/03/2012
Last updated
02/19/2021
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