Provider Demographics
NPI:1528512423
Name:AMRINE, SARAH (NP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:AMRINE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:STE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1130 MEDICAL ARTS BLVD
Practice Address - Street 2:STE 250
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3432
Practice Address - Country:US
Practice Address - Phone:765-298-4282
Practice Address - Fax:765-298-4989
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71006555A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201389110Medicaid
INP01723957OtherRR MEDICARE
IN266180731Medicare PIN