Individual
TRICIA HERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10122 E 10TH ST, INDIANAPOLIS, IN 46229-2663
(317) 355-5717
(317) 898-9760
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01064913A
IN
207Q00000X
Family Medicine Physician
036-104483
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036104483
—
IL
01
—
P01291571
RAILROAD MEDICARE
IN
Enumeration date
07/02/2006
Last updated
06/09/2021
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