Individual
TERESA A LAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1000 E MAIN ST, DANVILLE, IN 46122-1948
(317) 745-4451
(317) 718-6740
Mailing address
1100 SOUTHFIELD DR STE 1370, PLAINFIELD, IN 46168-4300
(317) 837-5566
(317) 837-5580
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71004493A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71004493A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01347721
MEDICARE RR PTAN
IN
Enumeration date
06/05/2013
Last updated
07/08/2021
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