Provider Demographics
NPI:1497122683
Name:AMIANO, GINA L (NP)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:L
Last Name:AMIANO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 13059
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4021
Mailing Address - Country:US
Mailing Address - Phone:317-583-3022
Mailing Address - Fax:317-583-2199
Practice Address - Street 1:3838 N 1ST AVE
Practice Address - Street 2:STE D
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-3326
Practice Address - Country:US
Practice Address - Phone:812-425-0300
Practice Address - Fax:812-428-8400
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN281971712A363LF0000X
IN71005914A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily