Provider Demographics
NPI:1013479260
Name:DECH, AMANDA JOY (MSN/FNP-C)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JOY
Last Name:DECH
Suffix:
Gender:F
Credentials:MSN/FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-1465
Mailing Address - Country:US
Mailing Address - Phone:219-445-6469
Mailing Address - Fax:219-245-6600
Practice Address - Street 1:3229 BROADWAY STE 205
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46409-1038
Practice Address - Country:US
Practice Address - Phone:219-806-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28168353A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily