| Amy Van De Wielle, | |
|
303 S Nappanee St, Elkhart, IN 46514-2066 | |
| (574) 296-3200 | |
| Not Available |
| Full Name | Amy Van De Wielle |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 4 Years |
| Location | 303 S Nappanee St, Elkhart, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144953902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 71012888A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Elkhart General Hospital | Elkhart, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Privia Medical Group Indiana, Llc | 2365341674 | 39 |
| Entity Name | Privia Medical Group Indiana, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568147809 PECOS PAC ID: 2365341674 Enrollment ID: O20040110000052 |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Van De Wielle, Po Box 39491, Belfast, ME 04915-1248 Ph: (574) 296-3200 | Amy Van De Wielle, 303 S Nappanee St, Elkhart, IN 46514-2066 Ph: (574) 296-3200 |
Elizabeth W Maina, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052 | |
Ms. Cecilia Mumbi Maina, FNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052 | |
Mr. Kenneth Francis Raderstorf Iii, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3301 County Road 6 E, Elkhart, IN 46514 Phone: 574-266-5342 Fax: 574-266-5847 | |
Rosemary J Eash, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1627 E Bristol St, Elkhart, IN 46514 Phone: 574-262-0313 Fax: 574-262-8163 | |
Lorraine Doris Swartzentruber, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052 | |
Ashley Marie Brunt, NURSE PRA Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 500 Arcade Ave Ste 400, Elkhart, IN 46514 Phone: 574-522-2284 Fax: 574-522-3952 | |
Mrs. Catherine E Dos Santos, MSN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3421 S Main St, Elkhart, IN 46517 Phone: 574-295-7178 Fax: 574-295-8822 |