Provider Demographics
NPI:1578516670
Name:GOLDEN, AMELIA ANN (FNP- C)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:ANN
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:FNP- C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47327-1510
Mailing Address - Country:US
Mailing Address - Phone:765-478-4420
Mailing Address - Fax:765-478-4420
Practice Address - Street 1:498 NW 18TH STREET
Practice Address - Street 2:BX 275, BLG 414
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47327-2851
Practice Address - Country:US
Practice Address - Phone:765-966-5700
Practice Address - Fax:765-966-5733
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001647A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily