Amanda Diane Anderson, FNP
Individual provider Active NPI Nurse Practitioner · Shelbyville, IN
NPI 1508394792 · NPPES record last updated Oct 14, 2021
Key facts
- NPI
- 1508394792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 71007255A (IN)
- Practice address
- 2451 Intelliplex Dr Ste 240
Shelbyville, IN 46176-8581 - Phone
- (317) 398-7337
- NPI assigned
- Jun 1, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71007255A | IN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients | |
| Major Hospital | Past | Accepting new patients | |
| Major Hospital | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71007255A | IN | Yes |
Addresses
Primary practice location
2451 Intelliplex Dr Ste 240
Shelbyville, IN 46176-8581
Mailing address
30 W Rampart St Ste 200
Shelbyville, IN 46176-8846
Phone (317) 421-2012
Other names
- Amanda Diane Smith
Other providers in Shelbyville, IN
- Basma Aly
- American Health Network of Indiana, LLC
- Kelli Amrhein
- Anchor Counseling LLC
- Emily Ann Kapunan Andaya
- Anna Annee
- Priscilla Antwi
- Kimberly Ann Arreola
- Raymond Denis Arsenault
- Assisted Living Concepts Inc
All providers in Shelbyville, IN · Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.