Gomez, Amanda M
Gomez, Amanda M is an individual health care provider with primary practice located at 1701 N Senate Blvd , Indianapolis IN 46202-1239. She recently has 4 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Gomez, Amanda M can be contacted via phone (317) 944-5000.Contact Information
Primary practice address
1701 N Senate Blvd
Indianapolis IN 46202-1239
Phone: (317) 944-5000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 71005658A | Indiana |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 71005658A | Indiana |
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | 71005658A | Indiana |
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 71005658A | Indiana |
Profile Details
| NPI number | 1518335124 |
|---|---|
| LBN Legal business name | Gomez, Amanda M |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2015 |
| Last updated | Dec 11th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518335124 | NPPES |
| Indiana | MEDICAID | 201330310 | |
| Indiana | Other | 000000966323 | |
| Indiana | Other | 000001271031 | |
| Indiana | Other | Q00734130 |
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