Individual
LOICE MUKONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 N POST RD STE 4, INDIANAPOLIS, IN 46219-4225
(317) 405-8833
(317) 672-2398
Mailing address
1801 RED PHISTER DR, AVON, IN 46123-7172
(317) 272-1383
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28140253A
IN
363L00000X
Nurse Practitioner
Primary
71003823A
IN
363LF0000X
Family Nurse Practitioner
71003823
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201052050
—
IN
Enumeration date
02/13/2012
Last updated
05/05/2022
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