Individual
ANGELA LUESSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2040 N SHADELAND AVE, INDI, IN 46219-1734
(317) 355-1800
(317) 355-1803
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71006396A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71006396A
IN
364SP0810X
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
71006396
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201381650
—
IN
Enumeration date
08/15/2016
Last updated
09/24/2025
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