MEDICARE: AMY K REISING NP

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	363L00000X	Nurse Practitioner	71001405A	IN

General Provider Information

NPI Number	:	1326014655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY K REISING NP

Provider Business Mailing Address
First Line	:	PO BOX 1510
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47706-1510
Country	:	US
Telephone Number	:	812-479-3153
Fax Number	:	812-473-8166

Provider Business Practice Location Address
First Line	:	6221 PHYSICIANS CT
Second Line	:	SUITE 1
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-4031
Country	:	US
Telephone Number	:	812-479-3153
Fax Number	:	812-473-8166

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

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	12/02/2013

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Directions to “ AMY K REISING NP” Practice Location

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