Provider Demographics
NPI:1982860466
Name:BOONE, AMY JANE (RN)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:JANE
Last Name:BOONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 E CHRISTY ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-2130
Mailing Address - Country:US
Mailing Address - Phone:765-664-9575
Mailing Address - Fax:
Practice Address - Street 1:107 S PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-3831
Practice Address - Country:US
Practice Address - Phone:765-664-9091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28100251A163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development