DESTINY ETHERIDGE

INDIANAPOLIS, IN
NPI1871099002
Former NameDESTINY DANIELLE SPENCE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IN  01085265A)
Additional Taxonomies207Q00000X Family Medicine
(Licence: KY  55932)
207Q00000X Family Medicine
(Licence: KY  TP282)
207QA0401X Family Medicine, Addiction Medicine
(Licence: KY  55932)
Enumeration Date2018-04-05
Last Update Date2026-07-13
Business Address
DESTINY ETHERIDGE MD
8820 S MERIDIAN ST STE 120
INDIANAPOLIS, IN 46217-6057
Phone number: 317-865-6700
Mailing Address
DESTINY ETHERIDGE MD
250 N SHADELAND AVE
INDIANAPOLIS, IN 46219-4959
Phone number: