Healthcare Provider Details

I. General information

NPI: 1871319681
Provider Name (Legal Business Name): AMANDA FERBER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2024
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8135 CALUMET AVE
MUNSTER IN
46321-1701
US

IV. Provider business mailing address

242 LANDALE DR
VALPARAISO IN
46385-7976
US

V. Phone/Fax

Practice location:
  • Phone: 219-513-2000
  • Fax:
Mailing address:
  • Phone: 219-929-7666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71016014A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: