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Individual

SUSAN ANNE FAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN MSN MSW LCSW CPNP

Contact information

Practice address
8710 N MERIDIAN ST, STE 100C, INDIANAPOLIS, IN 46260-5389
(317) 663-7302
(317) 735-9638
Mailing address
8710 N MERIDIAN ST, STE 100C, INDIANAPOLIS, IN 46260-5389
(317) 663-7302
(317) 735-9638

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
34003872
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71001242A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000212827
BCBS
01
000000282033
BCBS
Enumeration date
05/17/2006
Last updated
09/11/2025
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