Healthcare Provider Details

I. General information

NPI: 1699685065
Provider Name (Legal Business Name): KATHRYN AMOS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 HEALTHY WAY
EVANSVILLE IN
47715-1180
US

IV. Provider business mailing address

521 E LINCOLN AVE
CHANDLER IN
47610-9577
US

V. Phone/Fax

Practice location:
  • Phone: 812-450-8720
  • Fax: 812-402-1057
Mailing address:
  • Phone: 812-459-4235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71018649A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: