Individual
ANNA MARIE AVELINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4200 S EAST ST, INDIANAPOLIS, IN 46227-1534
(317) 991-7600
(317) 215-7030
Mailing address
PO BOX 746720, ATLANTA, GA 30374-6720
(312) 733-9730
(773) 866-8014
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28083833A
IN
363L00000X
Nurse Practitioner
Primary
71001885A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000491145
ANTHEM BCBC
IN
05
—
200511060A
—
IN
01
—
P00220524
RR MEDICARE
IN
Enumeration date
10/20/2005
Last updated
11/18/2022
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