Provider Demographics
NPI:1912259391
Name:AFFORDABLE MEDICAL CONSULTANTS, LLC
Entity type:Organization
Organization Name:AFFORDABLE MEDICAL CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIEASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:317-496-7976
Mailing Address - Street 1:14230 CALMING WATERS
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-6661
Mailing Address - Country:US
Mailing Address - Phone:371-496-7976
Mailing Address - Fax:
Practice Address - Street 1:14230 CALMING WATERS
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-6661
Practice Address - Country:US
Practice Address - Phone:371-496-7976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003015A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM400052491OtherMEDICARE ID
INM400067777OtherMEDICARE ID
IN1053544536OtherNPI
IN1578624567OtherNPI