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Individual

SAMANTHA L DUGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1701 N SENATE AVE, INDIANAPOLIS, IN 46202-5306
(317) 274-0275
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28266186A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001542312
ANTHEM PTAN
IN
01
000001602054
ANTHEM PTAN
IN
05
300050295
IN
Enumeration date
05/19/2021
Last updated
12/03/2024
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