Individual
THERESA KAY MENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8244 E. US 36, STE. 1100, HENDRICKS REGIONAL HEALTH IMMEDIATE CARE, AVON, IN 46123-9627
(317) 272-7500
(317) 272-7515
Mailing address
34 W 59TH ST, INDIANAPOLIS, IN 46208-1513
(317) 257-2636
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
70000199A
IN
363LF0000X
Family Nurse Practitioner
70000199A
IN
Other
Enumeration date
09/29/2006
Last updated
08/20/2010
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