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Organization

INDYSTATHEALTHEDU, LLC

Active
Parent organization
INDYSTATHEALTHEDU, LLC
Other names
IndyStatHealth, IndyStatHealth Care Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
INDYSTATHEALTHEDU, LLC
Authorized official
JERUSHA KETURAH SEUNG APRN, FNP-C, WCC (MEDICAL DIRECTOR AND DIRECTOR OF ED)
(317) 260-9333
Entity
Organization

Contact information

Practice address
9465 COUNSELORS ROW STE 200, INDIANAPOLIS, IN 46240-3817
(317) 260-9333
Mailing address
9465 COUNSELORS ROW STE 200, INDIANAPOLIS, IN 46240-3817
(317) 260-9333

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207QG0300X
Geriatric Medicine (Family Medicine) Physician
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician

Other

Enumeration date
08/20/2020
Last updated
04/26/2024
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