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Organization

DRAGONFLY PRIMARY CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRYSTAL DAWN WILES FNP-BC (OWNER., AUTHORIZED OFFICIAL)
(317) 501-8496
Entity
Organization

Contact information

Practice address
6835 E SOUTHPORT RD STE D, INDIANAPOLIS, IN 46237-9714
(317) 501-8496
Mailing address
6835 E SOUTHPORT RD STE D, INDIANAPOLIS, IN 46237-9714
(317) 501-8496

Taxonomy

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

Other

Enumeration date
07/19/2021
Last updated
07/19/2021
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