Provider Demographics
NPI:1174317259
Name:BRASHEAR, AMANDA JANE (PMHNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:JANE
Last Name:BRASHEAR
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3577 W COCKRELL RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-8710
Mailing Address - Country:US
Mailing Address - Phone:812-327-0171
Mailing Address - Fax:
Practice Address - Street 1:3577 W COCKRELL RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-8710
Practice Address - Country:US
Practice Address - Phone:812-327-0171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program