Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | 71007514A | IN |
Y | 363LP0222X | Nurse Practitioner Pediatrics (Critical Care) | 71007514A | IN |
NPI | 1023522539 |
---|---|
Provider Name | Amanda Behny Austin |
First Address | Indianapolis, IN 46290-1024 |
Second Address | Indianapolis, IN 46260-1902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2017 |
Last Update Date | 04/12/2017 |