Individual
AMY N ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
355 W 16TH ST, SUITE 5100, INDIANAPOLIS, IN 46202-2207
(317) 396-1300
(317) 329-3040
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28133507A
IN
363L00000X
Nurse Practitioner
71002674A
IN
363LA2100X
Acute Care Nurse Practitioner
Primary
71002674A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000736742
ANTHEM PTAN
IN
05
—
200909040
—
IN
Enumeration date
07/15/2008
Last updated
02/07/2025
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