Organization
AMANDA REGESTER PEDIATRIC HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA REGESTER PNP (SOLE-MEMBER)
(317) 450-8498
Entity
Organization
Contact information
Practice address
654 S WALKER ST, BLOOMINGTON, IN 47403-2159
(812) 369-4344
Mailing address
1535 S ANDREW CIR, BLOOMINGTON, IN 47401-7147
(317) 450-8498
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/04/2022
Last updated
04/02/2022
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