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Nursing Service Providers Registered Nurse Critical Care Medicine

Provider NPI: 1083970339

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
Tel: 317-944-0920  Fax: 317-963-5446

Business Mailing Address:
Tel: --  Fax: --

NPI Information:
NPI: 1083970339
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
N163WC0200XNursing Service Providers
Registered Nurse
Critical Care Medicine
Y363LA2100XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 363LA2100X





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