Individual
AINA CASTELLUCCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 577-4200
(317) 577-9503
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9384252
FL
367500000X
Certified Registered Nurse Anesthetist
11007212
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
RN9384252
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
095200112
MEDICARE PTAN
IN
01
—
1102690198
ANTHEM PTAN
IN
01
—
264430G41
MEDICARE PTAN
IN
05
—
300068847
—
IN
01
—
Q00408865
RAILROAD PTAN
IN
Enumeration date
05/29/2020
Last updated
04/22/2024
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