Individual
CHRISTINA HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7120 CLEARVISTA DR STE 2000, INDIANAPOLIS, IN 46256-1621
(317) 621-7120
(317) 621-7119
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
28141152A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000779562
ANTHEM
IN
05
—
201082530
—
IN
Enumeration date
07/27/2012
Last updated
11/27/2023
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