Individual
AMY BEDAN POFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN NPC
Contact information
Practice address
2051 CLEVIDENCE BLVD STE B, CLARKSVILLE, IN 47129
(812) 280-9145
(502) 280-6627
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71002491A
IN
363LA2200X
Adult Health Nurse Practitioner
28124768A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71002491A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001017617
ANTHEM - NCMA
KY
01
—
100930
SIHO - NCMA
KY
05
—
200905020
—
IN
01
—
71002491A
LICENSE
IN
Enumeration date
09/12/2007
Last updated
10/11/2021
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