Individual
TRICIA J SHORT-YODER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7979 N SHADELAND AVE, STE 200, INDIANAPOLIS, IN 46250-2042
(317) 621-4300
(317) 621-4301
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71002468A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000537741
ANTHEM
IN
05
—
200871850
—
IN
01
—
413960
WELLCARE
IN
01
—
P00817391
MEDICARE RR
IN
01
—
P01777172
MEDICARE RR
IN
Enumeration date
10/02/2007
Last updated
11/27/2023
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