Individual
MICHELLE S FISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1400 N RITTER AVE STE 370, INDIANAPOLIS, IN 46219-3098
(317) 355-1144
(317) 355-1155
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-1647
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28153865A
IN
363LF0000X
Family Nurse Practitioner
Primary
71007449A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300005878
—
IN
Enumeration date
08/07/2017
Last updated
11/27/2023
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