Individual
PRUDENCE I TWIGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3834 S EMERSON AVE, BUILDING C, SUITE 100, INDIANAPOLIS, IN 46203
(317) 782-1577
(317) 780-5539
Mailing address
PO BOX 3299, CARSON CITY, NV 89702-3299
(775) 222-0044
(888) 700-0187
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28105420A
IN
363L00000X
Nurse Practitioner
71000480A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71000480A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200195530A
—
IN
Enumeration date
10/31/2005
Last updated
08/02/2018
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