DIANNE R MODLESKI

INDIANAPOLIS, IN
NPI1679585939
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: IN  71002179A)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: IN  71002179A)
363LG0600X Nurse Practitioner, Gerontology
(Licence: IN  71002179A)
Enumeration Date2006-08-13
Last Update Date2013-10-23
Business Address
-- DIANNE R MODLESKI NP
1633 N CAPITOL AVE STE 322
INDIANAPOLIS, IN 46202-1476
Phone number: 317-962-2929
Mailing Address
-- DIANNE R MODLESKI NP
250 N SHADELAND AVE SUITE 130 - PROVIDER ENROLLMENT
INDIANAPOLIS, IN 46219-4959
Phone number: