Individual
CORTNIE N YODER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1402 E COUNTY LINE RD, INDIANAPOLIS, IN 46227-0963
(317) 887-7805
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7588
(317) 957-2749
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002556A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266180C42
TRADITIONAL MEDICARE
IN
05
—
300018552
—
IN
01
—
P02110480
MEDICARE RR
IN
Enumeration date
07/18/2018
Last updated
04/09/2019
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