Provider Demographics
NPI:1073034500
Name:HANDSHOE, AMBER N (NP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:N
Last Name:HANDSHOE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3270 INTERTECH DR
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46703-7325
Mailing Address - Country:US
Mailing Address - Phone:260-305-2622
Mailing Address - Fax:260-305-2555
Practice Address - Street 1:3270 INTERTECH DR
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:IN
Practice Address - Zip Code:46703-7325
Practice Address - Country:US
Practice Address - Phone:260-302-2622
Practice Address - Fax:260-305-2655
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71007199A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner