Provider Demographics
NPI:1245846963
Name:MCINTOSH, ABIGAIL ELIZABETH (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:ELIZABETH
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-450-4066
Mailing Address - Fax:812-450-3886
Practice Address - Street 1:309 N FIRST AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1218
Practice Address - Country:US
Practice Address - Phone:812-450-4066
Practice Address - Fax:812-450-3886
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28209562A163WM0705X
IN71010596A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical