Individual
SARA BODENMILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-4364
Mailing address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71001283A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71001283A
IN
Other
Enumeration date
01/31/2007
Last updated
05/25/2022
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