Provider Demographics
NPI:1801636196
Name:FORSTERLING, AMANDA S (MSN, WHNP-BC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:S
Last Name:FORSTERLING
Suffix:
Gender:F
Credentials:MSN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3854 WILD GROVE WAY
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-1062
Mailing Address - Country:US
Mailing Address - Phone:262-352-0098
Mailing Address - Fax:
Practice Address - Street 1:85 E US HIGHWAY 6 STE 330
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-8948
Practice Address - Country:US
Practice Address - Phone:219-462-6144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-25
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71015289A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty