Individual
MILDRED SUE MCMANUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN C-FNP
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-4273
(317) 988-2171
Mailing address
252 N ODELL ST, BROWNSBURG, IN 46112-2121
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP 04246
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020489
LA STATE BD NRS ID #
LA
05
—
1178209
—
LA
01
—
28172656A
RN LICENSE
IN
01
—
71002372A
NP REGISTRATION
IN
01
—
71002372B
CSR
IN
01
—
AP04246
LA SBON APRN LIC #
LA
Enumeration date
06/08/2005
Last updated
03/07/2023
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