Individual
CARISSA E HARPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
550 UNIVERSITY BLVD, STE 1295, INDIANAPOLIS, IN 46202-5149
(317) 944-8330
(317) 944-7648
Mailing address
250 N SHADELAND AVE, SUITE 130, PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
(317) 963-0860
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001445A
IN
Other
Enumeration date
11/30/2012
Last updated
07/09/2014
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