Individual
DANA MICHELE LARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
640 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5173
(317) 221-8300
Mailing address
640 ESKENAZI AVE STE 100, INDIANAPOLIS, IN 46202-5174
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71005640A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201350540
—
IN
01
—
P01678968
RR MEDICARE
IN
Enumeration date
08/06/2015
Last updated
10/06/2022
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