Individual
NATHAN JOSEPH WOEBKENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8433 HARCOURT RD STE 100, INDIANAPOLIS, IN 46260-2193
(317) 583-7600
Mailing address
8433 HARCOURT RD STE 100, INDIANAPOLIS, IN 46260-2193
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10001572A
IN
363AS0400X
Surgical Physician Assistant
Primary
10001572A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102283989
ANTHEM PTAN
IN
Enumeration date
07/30/2013
Last updated
10/28/2024
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