Organization
SUMMERFIELD FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE A SANDINE RN, MSN, ANP, BC (OWNER)
(317) 408-8480
Entity
Organization
Contact information
Practice address
11 DECLARATION DR, N, GREENWOOD, IN 46143-7283
(317) 886-7417
(317) 886-7671
Mailing address
11 DECLARATION DR, N, GREENWOOD, IN 46143-7283
(317) 886-7417
(317) 886-7681
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28084354
IN
207L00000X
Anesthesiology Physician
01042621A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71003812A
IN
363LF0000X
Family Nurse Practitioner
71000246A
IN
Other
Enumeration date
05/19/2011
Last updated
12/06/2011
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