Vagelatos, Amanda

Vagelatos, Amanda is an individual health care provider with primary practice located at 2250 173Rd St , Hammond IN 46323-2074. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Vagelatos, Amanda can be contacted via phone (765) 494-0111.

Contact Information

Primary practice address
2250 173Rd St Hammond IN 46323-2074
Phone: (765) 494-0111
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 28189650A Indiana

Profile Details

NPI number 1023431814
LBN Legal business name Vagelatos, Amanda
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2014
Last updated Oct 2nd, 2023 - about 3 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 1023431814 NPPES
Indiana MEDICAID 201214860
Indiana Other 71004816A

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