Individual
IBITAYO K ARISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3850 SHORE DR STE 315, INDIANAPOLIS, IN 46254-4693
(317) 429-0061
Mailing address
8471 BALLYSHANNON DR, BROWNSBURG, IN 46112-7320
(317) 985-5899
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71014315A
IN
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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