Provider Demographics
NPI:1528074333
Name:FUHRER, AMANDA R (PA-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:R
Last Name:FUHRER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:R
Other - Last Name:TUGGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:679 E COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1049
Mailing Address - Country:US
Mailing Address - Phone:317-807-1266
Mailing Address - Fax:317-859-4269
Practice Address - Street 1:12188-A N. MERIDIAN ST STE 200
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4410
Practice Address - Country:US
Practice Address - Phone:317-564-5100
Practice Address - Fax:317-564-5556
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10000603A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN970030541OtherMEDICARE RAILROAD
IN000000340607OtherANTHEM PIN NUMBER
IN1487680518OtherGROUP NPI
IN069350JMedicare PIN
IN597870TMedicare PIN
INP80550Medicare UPIN
IN069340LMedicare PIN
IN896480XMedicare PIN
IN677730YMedicare PIN