Individual
ALISHA NICOLLE PANKIW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1036 S RANGELINE RD, CARMEL, IN 46032-2544
(317) 569-1413
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71006559A
IN
363LF0000X
Family Nurse Practitioner
28169666-A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006559A
IN
Other
Enumeration date
02/24/2016
Last updated
12/22/2020
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