Individual
WALTER ANDREW JAY MANDERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
13345 ILLINOIS ST, CARMEL, IN 46032-3318
(317) 396-1300
(317) 396-1346
Mailing address
13345 ILLINOIS ST, CARMEL, IN 46032-3318
(317) 396-1300
(317) 396-1346
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28199259A
IN
363L00000X
Nurse Practitioner
71009973A
IN
363LA2100X
Acute Care Nurse Practitioner
Primary
71009973A
IN
Other
Enumeration date
03/12/2020
Last updated
03/17/2023
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