Individual
MICHELLE E WRIGHT MAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11911 N MERIDIAN ST STE 170, CARMEL, IN 46032-6928
(317) 621-0790
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71000690A
IN
363LF0000X
Family Nurse Practitioner
11479
OH
363LF0000X
Family Nurse Practitioner
Primary
71000690A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000709117
ANTHEM
IN
05
—
200454260
—
IN
Enumeration date
08/28/2007
Last updated
03/26/2025
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