Provider Demographics
NPI:1508593096
Name:PLEW, AMY (RN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:PLEW
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 CHESTER EAST DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-3730
Mailing Address - Country:US
Mailing Address - Phone:843-290-7732
Mailing Address - Fax:
Practice Address - Street 1:6626 CHESTER EAST DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-3730
Practice Address - Country:US
Practice Address - Phone:843-290-7732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INL-159666163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant