Individual
LAUREN N. SALLESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 WALTER SCHOLER DR, LAFAYETTE, IN 47909-6303
(765) 448-8000
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28229757A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006434A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001040781
ANTHEM PROVIDER NUMBER
IN
05
—
201380410
—
IN
Enumeration date
06/10/2016
Last updated
02/24/2021
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