MEDICARE: FLORENCE AMANCHUKWU

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	71016856A	IN
2	363LG0600X	Gerontology Nurse Practitioner	71016856A	IN
3	363LP2300X	Primary Care Nurse Practitioner	71016856A	IN

General Provider Information

NPI Number	:	1487468401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLORENCE AMANCHUKWU

Provider Business Mailing Address
First Line	:	3302 S EAST ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-1118
Country	:	US
Telephone Number	:	317-970-0647
Fax Number	:

Provider Business Practice Location Address
First Line	:	3302 S EAST ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-1118
Country	:	US
Telephone Number	:	317-970-0647
Fax Number	:

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

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	06/09/2026

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Directions to “ FLORENCE AMANCHUKWU ” Practice Location

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