Individual
CHELSEA LEE HARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
714 N SENATE AVE STE 100, INDIANAPOLIS, IN 46202-3297
(317) 439-7764
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004312A
IN
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104149647
ANTHEM PTAN
IN
05
—
300089455
—
IN
Enumeration date
08/31/2023
Last updated
11/01/2024
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