Individual
MS. AMANDA JO VELEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3512 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 483-9081
(260) 483-9196
Mailing address
3512 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 483-9081
(260) 483-9196
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28169002A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71006528A
IN
Other
Enumeration date
05/12/2016
Last updated
09/26/2016
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