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Individual

LEANN E GUERRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-0582
(317) 962-2082
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71006180A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201358120
IN
01
233690121
MEDICARE PTAN
IN
05
300047591
IN
01
Q00261161
RAILROAD PTAN
IN
Enumeration date
01/09/2016
Last updated
12/18/2023
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