Individual
MARY K FULLER-NAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
13450 N MERIDIAN ST STE 145, CARMEL, IN 46032-1484
(317) 338-8788
Mailing address
13450 N MERIDIAN ST STE 145, CARMEL, IN 46032-1484
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
71006575A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006575A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300039160
—
IN
Enumeration date
08/26/2016
Last updated
05/30/2024
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