Individual
LAURA ELIZABETH SERTICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
965 EMERSON PKWY STE B, GREENWOOD, IN 46143-6274
(317) 865-0055
(317) 865-0056
Mailing address
DEPT. 453 PO BOX 1000, MEMPHIS, TN 38148-0001
(828) 575-2625
(828) 350-3714
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71008895A
IN
363LF0000X
Family Nurse Practitioner
71008895A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300025467
—
IN
01
—
IN1125025
MEDICARE PTAN
IN
01
—
IN1127024
MEDICARE PTAN
IN
Enumeration date
03/04/2019
Last updated
10/30/2023
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