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Individual

BARBARA DEICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
2900 16TH ST, BEDFORD, IN 47421-3510
(812) 275-5352
(812) 275-1374
Mailing address
2900 16TH ST, BEDFORD, IN 47421-3510
(812) 275-5352
(812) 275-1374

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000986A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000307496
ANTHEM PROVIDER #
IN
05
200171390A
IN
Enumeration date
09/08/2005
Last updated
02/06/2020
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