Individual
SANDRA K VANWYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6820 PARKDALE PL, SUITE 212, INDIANAPOLIS, IN 46254-6601
(317) 329-7022
(317) 329-7030
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
28079750A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201151240
—
IN
Enumeration date
02/13/2008
Last updated
11/23/2020
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