Individual
ALICIA HOLLY OTTENWELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
426 S ALABAMA ST STE 100, INDIANAPOLIS, IN 46225-3301
(317) 528-2489
(317) 528-3770
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28226461A
IN
363LF0000X
Family Nurse Practitioner
Primary
71007384A
IN
Other
Enumeration date
06/26/2017
Last updated
08/15/2023
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