Healthcare Provider Details

I. General information

NPI: 1134525645
Provider Name (Legal Business Name): AMY R AESCHLIMAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2014
Last Update Date: 02/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 E. 5TH STREET SUITE B
BURLINGTON IN
46915-1758
US

IV. Provider business mailing address

425 E. 5TH STREET SUITE B
BURLINGTON IN
46915-1758
US

V. Phone/Fax

Practice location:
  • Phone: 765-566-5055
  • Fax: 765-566-5050
Mailing address:
  • Phone: 765-566-5055
  • Fax: 765-566-5050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005231A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: