Individual
SUSAN M HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8202 CLEARVISTA PKWY, SUITE 7A, INDIANAPOLIS, IN 46256-1445
(317) 621-6300
(317) 621-6310
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
(317) 621-6300
(317) 621-6310
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71000009A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000655113
ANTHEM
IN
01
—
000000655709
ANTHEM
IN
01
—
000000659326
ANTHEM
IN
01
—
000000667919
ANTHEM
IN
05
—
200963890
—
IN
Enumeration date
03/25/2006
Last updated
11/27/2023
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