Individual
MS. JANICE SUE DALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1650 N COLLEGE AVE, INDIANAPOLIS, IN 46202-1715
(317) 396-0288
(317) 396-3635
Mailing address
5902 GETZ LN, INDIANAPOLIS, IN 46254-2877
(317) 396-0288
(317) 927-3635
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28109095A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28109095A
NURSES LICENSE
IN
Enumeration date
03/07/2007
Last updated
07/08/2007
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