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Search › Indiana › 163W00000X

Amber Stout, RN, BSN

NPI 1780404152 · on the registry since 2024 · sole proprietor

Practice

Address
210 Meijer Dr
Suite A
Lafayette, IN 47905
Phone
(765) 838-5750
Fax
(765) 838-5751
Organisation at this address
Revive Ketamine And Wellness Pc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
2

Registry record

Primary taxonomy
163W00000X
163W00000X
Also registered as
163W00000X
Licence states on file
IN
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2024-10-11

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana