Healthcare Provider Details

I. General information

NPI: 1154553196
Provider Name (Legal Business Name): ANN MARIE VASH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2009
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 A ST NE STE 9
LINTON IN
47441-1612
US

IV. Provider business mailing address

1600 A ST NE STE 9
LINTON IN
47441-1612
US

V. Phone/Fax

Practice location:
  • Phone: 812-847-7005
  • Fax: 812-847-5309
Mailing address:
  • Phone: 812-847-7005
  • Fax: 812-847-5309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71003117A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: