Healthcare Provider Details

I. General information

NPI: 1700703303
Provider Name (Legal Business Name): AMRITA LUDLOW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 RILEY HOSPITAL DR # 208
INDIANAPOLIS IN
46202-5109
US

IV. Provider business mailing address

575 RILEY HOSPITAL DR # 4300
INDIANAPOLIS IN
46202-5272
US

V. Phone/Fax

Practice location:
  • Phone: 317-274-4779
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28273682A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number7108132A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: