AMANDA LAVENDER (NPI# 1033768569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033768569 |
| Entity Type | Individual |
| Full Name | AMANDA LAVENDER |
| Credential | PMHNP |
| Practice Address |
727 W 2nd St Bloomington IN 47403-2209 |
| Mailing Address |
2125 16th St Bedford IN 47421-3003 |
| Practice Telephone | 8123533450 |
| Practice Fax Number | 8123533451 |
| Enumeration Date | 2019-09-07 |
| Last Update Date | 2020-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
71009545A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
28194541A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2125 16th St, Bedford, IN 474213003 | 8122754053 | 8122755494 |
| 727 W 2nd St, Bloomington, IN 474032209 | 8123533450 | 8123533451 |
| Street Address |
727 W 2ND ST |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47403-2209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265452866 | Karen Vanarsdale | Social Worker | 727 W 2nd St, Bloomington, IN 47403-2209 | 2006-07-20 |
| 1881291763 | Dallas Joann England | Social Worker | 727 W 2nd St, Bloomington, IN 47403-2209 | 2020-10-05 |
| 1649882812 | Mindy Lynn Metzcar | Social Worker | 727 W 2nd St, Bloomington, IN 47403-2209 | 2020-08-19 |
| 1144845405 | Judith Ann Wiser | Student in an Organized Health Care Education/Training Program | 727 W 2nd St, Bloomington, IN 47403-2209 | 2020-06-12 |
| 1801422779 | Shelby Nicole Drake | Dietitian, Registered | 727 W 2nd St, Bloomington, IN 47403-2209 | 2020-03-23 |
| 1396218590 | Dayana Ferrera | Counselor | 727 W 2nd St, Bloomington, IN 47403-2209 | 2019-01-10 |
| 1467936070 | Dawn Marie Johnson | Registered Nurse | 727 W 2nd St, Bloomington, IN 47403-2209 | 2018-09-19 |
| 1871005231 | Lindsay Wilson | Dietitian, Registered | 727 W 2nd St, Bloomington, IN 47403-2209 | 2017-10-25 |
| 1992220776 | Robin Elaine Parker | Dietitian, Registered | 727 W 2nd St, Bloomington, IN 47403-2209 | 2017-08-14 |
| 1326584772 | Lindsay M Potts | Social Worker | 727 W 2nd St, Bloomington, IN 47403-2353 | 2017-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
| 1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
| 1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
| 1295276160 | Indiana Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 1004 W 1st Street, Bloomington, IN 47403 | 2017-03-13 |
| 1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
| 1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
| 1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
| 1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
| 1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
| 1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
| Find all providers in zip 47403 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134780851 | Eric Lyakhovetsky | Nurse Practitioner | 327 W Saidah Rd, Bloomington, IN 47404-8965 | 2019-06-24 |
| 1477822344 | Wenjing Cao | Nurse Practitioner | 108 W. Market, Bloomington, IL 61701 | 2011-12-22 |
| 1679684203 | Colleen S Odonnell | Nurse Practitioner | 1603 W Old Shakopee Rd, Bloomington, MN 55431-3065 | 2006-08-31 |
| 1558970517 | Randy Bargo | Nurse Practitioner | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2020-07-27 |
| 1750921870 | Lotus Integrated Care, LLC | Nurse Practitioner | 654 S Walker St, Bloomington, IN 47403-2159 | 2020-01-07 |
| 1396215786 | Hui Shi Serena Loh | Nurse Practitioner | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2018-11-28 |
| 1922583285 | Bettina Ervin-rodgers | Nurse Practitioner | 108 W Market St, Bloomington, IL 61701-3918 | 2018-10-02 |
| 1710479753 | Kevin Nelson Moore | Nurse Practitioner | 550 S Adams St, Bloomington, IN 47403 | 2018-06-05 |
| 1205287513 | Stephanie B. Pemberton | Nurse Practitioner | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2016-06-28 |
| 1578942348 | Brandee Kay Marksberry | Nurse Practitioner | 445 S Landmark Ave, Bloomington, IN 47403-5004 | 2015-05-26 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47403 |
Please comment or provide details below to improve the information on AMANDA LAVENDER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.