Individual
MRS. DEANNA DALE MOTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
8501 HARCOURT RD, INDIANAPOLIS, IN 46260-2046
(317) 875-9105
(317) 808-8802
Mailing address
8501 HARCOURT RD, INDIANAPOLIS, IN 46260-2046
(317) 875-9105
(317) 875-8638
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71003145A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000801153
ANTHEM
IN
05
—
201078070
—
IN
Enumeration date
09/04/2009
Last updated
04/01/2024
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