Individual
DIANE ELAINE FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8301 HARCOURT RD, RADIATION ONCOLOGY DEPT, STE 100, INDIANAPOLIS, IN 46260-2081
(317) 415-6783
(317) 415-6758
Mailing address
6100 W 96TH ST, SUITE 125, INDIANAPOLIS, IN 46278-6005
(317) 715-1800
(317) 715-6200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001509A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000864920
ANTHEM
IN
05
—
201216930
—
IN
01
—
71001509B
APN CSR
IN
Enumeration date
08/22/2007
Last updated
03/07/2023
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