Individual
AMBER NICOLE STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
210 MEIJER DR, SUITE A, LAFAYETTE, IN 47905
(765) 838-5750
(765) 838-5751
Mailing address
1538 N 880 W, KOKOMO, IN 46901
(765) 480-3863
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28176300A
IN
163W00000X
Registered Nurse
28176300C
IN
Other
Enumeration date
10/11/2024
Last updated
10/11/2024
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