Basic Information
Provider Information
NPI: 1396260782
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABUASABEH
FirstName: AMY
MiddleName: GREENFIELD
NamePrefix:  
NameSuffix:  
Credential: PMHNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3276
Address2:  
City: EVANSVILLE
State: IN
PostalCode: 477313276
CountryCode: US
TelephoneNumber: 8124730181
FaxNumber: 8124735822
Practice Location
Address1: 7300 E INDIANA ST STE 103
Address2:  
City: EVANSVILLE
State: IN
PostalCode: 477152794
CountryCode: US
TelephoneNumber: 8124018008
FaxNumber: 8124018201
Other Information
ProviderEnumerationDate: 08/07/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808X71007352AINY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

ID Information
IDTypeStateIssuerDescription
71007352B01INCSROTHER
71007352A01INAPN PRESCRIPTIVE AUTHORITYOTHER


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