AMY JENE ELLINGWOOD ANP NPI 1235486499

NPI Information

NPI: 1235486499
Provider Name: AMY JENE ELLINGWOOD, ANP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Address:
1630 LAFAYETTE RD STE 200
CRAWFORDSVILLE, IN
ZIP 47933
Phone: (765) 359-2230
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Amy Jene Ellingwood, ANP is an adult health nurse practitioner in Crawfordsville, IN. Amy Jene Ellingwood, ANP NPI is 1235486499. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1630 LAFAYETTE RD STE 200
CRAWFORDSVILLE, IN
ZIP 47933-092
Phone: (765) 359-2230
Fax: (765) 359-2236

The enumeration date for this NPI number is 8/7/2012 and was last updated on 3/17/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	71004165A	INDIANA	Yes
2	363LA2200X	Nurse Practitioner	Adult Health	2012011503	INDIANA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	201115580	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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