Individual
AUDREY R ALCALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1515 S 19TH ST, ELWOOD, IN 46036-2941
(765) 298-2800
(765) 298-2820
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
(765) 298-5280
(765) 552-3351
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71003418A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200999630
—
IN
01
—
P01213055
RR MEDICARE PTAN
IN
Enumeration date
10/20/2010
Last updated
11/27/2023
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