Provider Demographics
NPI:1316370638
Name:DIERSING, AMY SCHMOLL (FNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:SCHMOLL
Last Name:DIERSING
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4435 TARRAGON DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-3671
Mailing Address - Country:US
Mailing Address - Phone:317-340-3092
Mailing Address - Fax:
Practice Address - Street 1:7375 W US 52
Practice Address - Street 2:
Practice Address - City:NEW PALESTINE
Practice Address - State:IN
Practice Address - Zip Code:46163-8950
Practice Address - Country:US
Practice Address - Phone:317-861-4171
Practice Address - Fax:317-861-5325
Is Sole Proprietor?:No
Enumeration Date:2013-08-11
Last Update Date:2013-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN28154981A363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care