Provider Demographics
NPI:1629890181
Name:HUMPHRESS, ANNEMARIE JUDITH (DNP)
Entity type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:JUDITH
Last Name:HUMPHRESS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:ANNEMARIE
Other - Middle Name:JUDITH
Other - Last Name:CANNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:610 E WALNUT ST STE A
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-2460
Mailing Address - Country:US
Mailing Address - Phone:844-999-9019
Mailing Address - Fax:
Practice Address - Street 1:610 E WALNUT ST STE A
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-2460
Practice Address - Country:US
Practice Address - Phone:844-999-9019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71015953A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily