Provider Demographics
NPI:1255975165
Name:ANDRESS, ABBY (NP-C)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:ANDRESS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:ERTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:18051 RIVER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-7093
Mailing Address - Country:US
Mailing Address - Phone:317-674-0062
Mailing Address - Fax:317-885-2869
Practice Address - Street 1:18051 RIVER RD STE 101
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-7093
Practice Address - Country:US
Practice Address - Phone:317-674-0062
Practice Address - Fax:317-219-5783
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71009724A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300040964Medicaid