Individual
HANNAH E WHEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1030 W MICHIGAN ST, INDIANAPOLIS, IN 46202-5201
(317) 948-7583
(317) 968-1118
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004007A
IN
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264431081
MEDICARE PTAN
IN
05
—
300076051
—
IN
Enumeration date
08/15/2016
Last updated
09/28/2023
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