Individual
CHENAI M MVUNDURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7440 WOODLAND DR, INDIANAPOLIS, IN 46278-1720
(317) 268-2199
Mailing address
591 GIPPER WAY W APT F, AVON, IN 46123-0151
(317) 268-2199
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28199740A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28199740A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912199415
MEDICAID/MEDICARE
—
Enumeration date
09/10/2019
Last updated
07/23/2024
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