Individual
AMANDA OTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-BC
Contact information
Practice address
6050 STERLING CREEK RD, PORTAGE, IN 46368-7752
(219) 763-8112
Mailing address
6050 STERLING CREEK RD, PORTAGE, IN 46368-7752
(219) 763-8112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
71013680A
IN
Other
Enumeration date
02/01/2023
Last updated
01/06/2026
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