Individual
MRS. CAROL ELLEN ELDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1700 DIVIDEND DR, LOGANSPORT, IN 46947-1572
(574) 722-7407
(574) 735-0429
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
(317) 576-1333
(317) 576-1339
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001817A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000357698
ANTHEM BLUE CROSS
—
05
—
200503400
—
IN
Enumeration date
05/31/2005
Last updated
06/30/2011
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