Individual
VICKI A CLEVELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN BC
Contact information
Practice address
5150 SHELBYVILLE RD, INDIANAPOLIS, IN 46237-2601
(317) 782-1577
(888) 392-3210
Mailing address
5150 SHELBYVILLE RD, INDIANAPOLIS, IN 46237-2601
(317) 782-1577
(888) 392-3210
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28129743A
IN
363L00000X
Nurse Practitioner
Primary
71001372A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000351107
ANTHEM
IN
05
—
200382080A
—
IN
01
—
500027595
RR MEDICARE
IN
Enumeration date
10/20/2005
Last updated
06/12/2014
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