Individual
CHIMI NUSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 415-7921
(317) 415-7922
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059
(574) 335-8707
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71005652A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000959681
BCBS
IN
05
—
201316100
—
IN
01
—
P02078333
MEDICARE RAIDROAD
IN
Enumeration date
08/25/2015
Last updated
12/23/2025
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