Individual
ALYSSA MILENBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7150 CLEARVISTA DR, INDIANAPOLIS, IN 46256-1695
(317) 621-6262
Mailing address
1545 N MERIDIAN ST, INDIANAPOLIS, IN 46202-2306
(317) 923-1491
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28207341A
IN
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
28207341A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300055449
—
IN
Enumeration date
08/21/2021
Last updated
10/25/2021
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