Individual
GRETA P PETERSON CLEMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1633 N CAPITOL AVE, STE 322, INDIANAPOLIS, IN 46202-1476
(317) 962-2929
(317) 962-2070
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71001060
IN
363LF0000X
Family Nurse Practitioner
Primary
71001060A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000387604
ANTHEM PTAN
IN
01
—
000000842401
ANTHEM PTAN
IN
05
—
200275780
—
IN
01
—
P01294247
RAILROAD PTAN
IN
Enumeration date
06/08/2006
Last updated
07/24/2025
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