Individual
AMY A SUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7956 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 436-2416
(260) 436-9662
Mailing address
7956 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 436-2416
(260) 436-9962
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002762A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200915040
—
IN
05
—
2877865
—
OH
Enumeration date
09/24/2008
Last updated
01/11/2011
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