Individual
ALYSSA RENEE BARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 963-0434
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71015269A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104205390
ANTHEM PTAN
IN
05
—
300090928
—
IN
Enumeration date
05/14/2024
Last updated
11/14/2024
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