Healthcare Provider Details

I. General information

NPI: 1932452083
Provider Name (Legal Business Name): AUTUMN NICOLE NONTE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2012
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S LANDMARK AVE
BLOOMINGTON IN
47403-3239
US

IV. Provider business mailing address

1185 N 1000 W
LINTON IN
47441-5282
US

V. Phone/Fax

Practice location:
  • Phone: 812-333-5973
  • Fax: 812-330-3681
Mailing address:
  • Phone: 812-847-5212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71004205A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: