Individual
ALISSA D MCDIVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
10255 COMMERCE DRIVE, SUITE 102, CARMEL, IN 46032
(317) 449-3958
(866) 400-7088
Mailing address
10255 COMMERCE DRIVE, SUITE 102, CARMEL, IN 46032
(317) 449-3958
(866) 400-7088
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002973A
IN
363LF0000X
Family Nurse Practitioner
COA.10035-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000709399
ANTHEM
IN
05
—
200997530
—
IN
Enumeration date
10/14/2008
Last updated
08/12/2024
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