Provider Demographics
NPI:1699038430
Name:ANDERSON, AIMEE LEIGH (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:LEIGH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:LEIGH
Other - Last Name:WELK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7120 CLEARVISTA DR STE 3200
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256
Practice Address - Country:US
Practice Address - Phone:317-621-7780
Practice Address - Fax:317-621-7783
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY42 421116363LW0102X
TX794616363LW0102X
NJ26NJ00418300363LW0102X
IN71005991A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201338610Medicaid
TX303804401Medicaid