Individual
EMILY SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1050 WISHARD BLVD, INDIANAPOLIS, IN 46202-2872
(972) 413-6459
Mailing address
8224 PRINCE WALES CT, PLANO, TX 75025-5521
(972) 413-6459
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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