Individual
MISTY ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1701 N SENATE AVE, INDIANAPOLIS, IN 46202-5306
(317) 993-9110
Mailing address
1701 N SENATE AVE, INDIANAPOLIS, IN 46202-5306
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28165899C
IN
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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