| NPI | 1366122566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES PENTICUFF Managing Member 317-349-7680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator |
| 163WC0400X Registered Nurse, Case Management | |
| 171M00000X Case Manager/Care Coordinator | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2023-07-21 |
| Last Update Date | 2026-07-23 |