Allison, Amanda Rae

Allison, Amanda Rae is an individual health care provider with primary practice located at 4130 Dutchmans Ln Ste 300 , Louisville KY 40207-4710. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Allison, Amanda Rae can be contacted via phone (502) 897-1794.

Contact Information

Primary practice address
4130 Dutchmans Ln Ste 300 Louisville KY 40207-4710
Phone: (502) 897-1794
Fax: (502) 897-3852
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3013010 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 3013010 Kentucky

Profile Details

NPI number 1144793563
LBN Legal business name Allison, Amanda Rae
Credentials APRN-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2019
Last updated Aug 27th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144793563 NPPES
Indiana Other 71010228A IN APRN LICENSE
Indiana MEDICAID 300041654 IN APRN LICENSE
Indiana MEDICAID 7100655180 IN APRN LICENSE
Indiana Other 3013010 IN APRN LICENSE

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