Provider Demographics
NPI:1114736600
Name:AVANCE, ARNETRICE
Entity type:Individual
Prefix:
First Name:ARNETRICE
Middle Name:
Last Name:AVANCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6437 AMICK WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-8600
Mailing Address - Country:US
Mailing Address - Phone:219-512-5713
Mailing Address - Fax:
Practice Address - Street 1:6437 AMICK WAY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-8600
Practice Address - Country:US
Practice Address - Phone:219-512-5713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care