Individual
ANNE PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1701 N SENATE BLVD, RM AG 001, INDIANAPOLIS, IN 46202-1239
(317) 962-3886
(317) 962-8652
Mailing address
950 N MERIDIAN ST, STE 500 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46204-3908
(317) 962-4941
(317) 962-4950
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000698
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200221870
—
IN
Enumeration date
08/04/2006
Last updated
11/19/2010
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