Provider Demographics
NPI:1851356455
Name:SEARS, AMY CHRISTINE (ACNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:CHRISTINE
Last Name:SEARS
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:CHRISTINE
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-905-3073
Mailing Address - Fax:513-441-1460
Practice Address - Street 1:231 ALBERT SABIN WAY
Practice Address - Street 2:ML 0585
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267
Practice Address - Country:US
Practice Address - Phone:513-558-5471
Practice Address - Fax:513-558-4309
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005245363L00000X
OH08815363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100065900Medicaid
OH611300608057OtherCARESOURCE
OH2653883Medicaid
IN200921470Medicaid
OHNP20944Medicare PIN
IN200921470Medicaid
KYP400023386Medicare PIN
OHEVNP20942Medicare PIN
OH611300608057OtherCARESOURCE
Q69896Medicare UPIN
OH2653883Medicaid
OHEVNP20943Medicare PIN