Individual
MEAGHAN STUTESMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 N RITTER AVE, SUITE 520, INDIANAPOLIS, IN 46219-3052
(317) 355-1234
(317) 355-1505
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28181093A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006041A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201343740
—
IN
01
—
P01678746
MEDICARE RAILROAD PTAN
IN
Enumeration date
12/03/2015
Last updated
06/14/2021
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