Healthcare Provider Details

I. General information

NPI: 1619227642
Provider Name (Legal Business Name): AMY M DIPPEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2012
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 W JEFFERSON ST STE 101
FRANKLIN IN
46131-2731
US

IV. Provider business mailing address

PO BOX 800
FRANKLIN IN
46131-0800
US

V. Phone/Fax

Practice location:
  • Phone: 317-736-6133
  • Fax: 317-736-6403
Mailing address:
  • Phone: 317-736-6133
  • Fax: 317-736-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71004149A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71004149A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: