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Individual

NADINE C HENNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
8075 N SHADELAND AVE, SUITE 200, INDIANAPOLIS, IN 46250-2693
(317) 621-8500
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002430
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200880370
IN
01
P01678727
MEDICARE RAILROAD PTAN
IN
Enumeration date
07/31/2007
Last updated
06/11/2021
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