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Individual

THERESE LYNN DEFABIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, ANP-BC

Contact information

Practice address
155 E MARKET ST, INDIANAPOLIS, IN 46204-3294
(866) 849-0692
(888) 973-8821
Mailing address
PO BOX 211699, EAGAN, MN 55121-3699
(866) 849-0692
(888) 973-8821

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
226556
OK
363L00000X
Nurse Practitioner
71000314
IN
363L00000X
Nurse Practitioner
APRN11037167
FL
363LA2200X
Adult Health Nurse Practitioner
0038109
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
71000314A
IN
363LA2200X
Adult Health Nurse Practitioner
C-APN.0103422-C-NP
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200855440
IN
Enumeration date
09/27/2006
Last updated
12/19/2025
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