Healthcare Provider Details

I. General information

NPI: 1962104760
Provider Name (Legal Business Name): ASIA ATKINSON PMHNP, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8103 E US HIGHWAY 36 STE 236
AVON IN
46123-7964
US

IV. Provider business mailing address

400 DOUBLE CREEK DR APT 203
PLAINFIELD IN
46168-5582
US

V. Phone/Fax

Practice location:
  • Phone: 463-308-5775
  • Fax: 463-243-4456
Mailing address:
  • Phone: 219-742-0953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71013709A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: