Individual
ELIZABETH J PIETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1633 N CAPITOL AVE, SUITE 301, INDIANAPOLIS, IN 46202-1476
(317) 962-3400
(317) 963-5446
Mailing address
250 N SHADELAND AVE, STE 130 - PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71004698A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71004698A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201198480
—
IN
Enumeration date
11/07/2013
Last updated
04/01/2014
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