| NPI | 1396172268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIANNA LYNN Office Manager 317-353-3811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71002414A) |
| Enumeration Date | 2013-10-08 |
| Last Update Date | 2014-01-21 |