Individual
ANTHONY COUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1007 HEATHERWOOD DR, GREENWOOD, IN 46143-6940
(317) 523-3846
Mailing address
1007 HEATHERWOOD DR, GREENWOOD, IN 46143-6940
(317) 523-3846
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71011187A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300051009
—
IN
01
—
Q001981696
RAILROAD MEDICARE
IN
Enumeration date
06/09/2021
Last updated
03/31/2025
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