Individual
LISA M FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1400 N. RITTER AVENUE, SUITE 370, INDIANAPOLIS, IN 46219-3098
(317) 355-1144
(317) 355-1155
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71004423A
IN
363LA2100X
Acute Care Nurse Practitioner
28104395A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000822694
ANTHEM
IN
05
—
201178520
—
IN
01
—
P01261819
MEDICARE RR PTAN
IN
Enumeration date
04/26/2013
Last updated
11/27/2023
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