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Individual

SHELLEY R PATTISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1801 N. SENATE BLVD, SUITE 310, INDIANAPOLIS, IN 46202-1252
(317) 962-2500
(317) 962-2515
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002295A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200851490
IN
Enumeration date
12/21/2006
Last updated
04/28/2014
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