Individual
ALEXIS NICOLE YOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP, RN
Contact information
Practice address
15108 LANSBURY LN, FISHERS, IN 46037-5536
(219) 808-3680
Mailing address
15108 LANSBURY LN, FISHERS, IN 46037-5536
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71003737A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201063660
—
IN
01
—
P01390905
MEDICARE RR PTAN
IN
Enumeration date
09/30/2011
Last updated
06/12/2019
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