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Individual

MALLORY LEE ANSLOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP-C

Contact information

Practice address
1550 E COUNTY LINE RD STE 201, INDIANAPOLIS, IN 46227-1082
(317) 355-1470
(317) 355-1475
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28193934A
IN
363LF0000X
Family Nurse Practitioner
Primary
71012673A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300066355
IN
Enumeration date
10/29/2020
Last updated
04/13/2026
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