| NPI | 1649650235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA BUNDY Clinic Project Specialist 317-632-0123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care |
| Additional Taxonomies | 207RI0200X Internal Medicine Infectious Disease |
| 363L00000X Nurse Practitioner (Licence: IN 71003339A) | |
| 363LA2200X Nurse Practitioner Adult Health | |
| 363LC1500X Nurse Practitioner Community Health | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2020-02-04 |