| NPI | 1518675917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE DAVIS CEO/Owner 317-827-2987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| 207R00000X Internal Medicine | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 208D00000X General Practice | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2024-08-07 |