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Organization

NEPHROLOGY ASSOCIATES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JANE L HARRIS (CREDENTIALING COORDINATOR)
(812) 491-6419
Entity
Organization

Contact information

Practice address
1401 PROFESSIONAL BLVD STE 101, EVANSVILLE, IN 47714-8011
(812) 491-6419
(812) 491-6419
Mailing address
1401 PROFESSIONAL BLVD STE 101, EVANSVILLE, IN 47714-8011
(812) 491-6419
(812) 491-6419

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1002461900
IN
05
100246190A
IN
01
CC9243
RAILROAD MEDICARE
IN
Enumeration date
05/12/2006
Last updated
05/22/2019
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