Individual
YELIZAVETA VAYL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
2010 W 86TH ST STE 111, INDIANAPOLIS, IN 46260
(317) 415-6580
Mailing address
10330 N MERIDIAN ST # 300, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71008168A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
GASTROENTEROLOGY
IN
Enumeration date
06/22/2018
Last updated
07/27/2018
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