| NPI | 1205342235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE E KONNERSMAN Executive Director 317-965-8641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2017-12-28 |