MEDICARE: ABBY NICOLE AMOS MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1245127711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBY NICOLE AMOS MS

Provider Business Mailing Address
First Line	:	6626 E 75TH ST STE 500
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2890
Country	:	US
Telephone Number	:	317-621-7347
Fax Number	:

Provider Business Practice Location Address
First Line	:	7120 CLEARVISTA DR STE 1700
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-1781
Country	:	US
Telephone Number	:	317-621-8985
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2025
Last Update Date	:	10/16/2025

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