Individual
AUDRA MARIE SMALLWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 880-7666
(317) 880-0448
Mailing address
1801 N SENATE BLVD, INDIANAPOLIS, IN 46202-1228
(317) 962-0582
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28244569A
IN
363L00000X
Nurse Practitioner
Primary
71014396A
IN
363LC0200X
Critical Care Medicine Nurse Practitioner
71014396A
IN
Other
Enumeration date
09/18/2023
Last updated
07/22/2025
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