MEDICARE: AMBER SAGER-GRINDLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	71015940A	IN

General Provider Information

NPI Number	:	1245052968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER SAGER-GRINDLE

Provider Business Mailing Address
First Line	:	1405 5TH ST
Second Line	:
City	:	LAWRENCEVILLE
State	:	IL
Zip	:	62439-3118
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 N GREEN RIVER RD
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-2942
Country	:	US
Telephone Number	:	812-901-5770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2024
Last Update Date	:	11/04/2024

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Directions to “ AMBER SAGER-GRINDLE ” Practice Location

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