Individual
MARCIE K JUDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1801 N SENATE BLVD, SUITE 230, INDIANAPOLIS, IN 46202-1252
(317) 962-5820
(317) 962-3916
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
71001641A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71001641A
IN
363LC0200X
Critical Care Medicine Nurse Practitioner
71001641A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000761454
ANTHEM PTAN
IN
01
—
000000799556
ANTHEM PTAN
IN
01
—
000001051614
ANTHEM PTAN
IN
05
—
201063160
—
IN
Enumeration date
06/11/2008
Last updated
02/12/2025
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