Individual
CHANEL HERBERTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5026 W US 52, NEW PALESTINE, IN 46163
(317) 861-4838
Mailing address
10610 PENTECOST RD, INDIANAPOLIS, IN 46239-9433
(317) 370-5315
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28209345A
IN
363LF0000X
Family Nurse Practitioner
Primary
71007579
IN
Other
Enumeration date
01/30/2017
Last updated
12/02/2019
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