Individual
MRS. LESIA DIANA MCBRIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
9550 ALLISONVILLE RD, INDIANAPOLIS, IN 46250-1201
(765) 208-0725
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28121341A
IN
363LF0000X
Family Nurse Practitioner
71004252A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201154000
—
IN
Enumeration date
10/15/2012
Last updated
02/19/2024
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