Individual
SHAINA E BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1800 N CAPITOL AVE, NP E-140, INDIANAPOLIS, IN 46202-1218
(317) 962-2894
(317) 963-5285
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71004546A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000966949
ANTHEM PTAN
IN
05
—
201329900
—
IN
Enumeration date
07/18/2013
Last updated
02/10/2025
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