| NPI | 1548553803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A SANDINE Owner 317-408-8480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71003812A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28084354) |
| 207L00000X Anesthesiology (Licence: IN 01042621A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71000246A) | |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2011-12-06 |