Individual
REBBI C COE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4069 TAHOE DR, INDIANAPOLIS, IN 46235-8834
(317) 737-0008
Mailing address
11432 MUTZ CIR, INDIANAPOLIS, IN 46229-2246
(317) 737-0008
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27072702A
IN
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
09/21/2020
Last updated
01/10/2022
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