Individual
MICHELE A O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1800 N CAPITOL AVE, NP E140, INDIANAPOLIS, IN 46202-1218
(317) 962-2894
(317) 963-5285
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
28085394A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71003411A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000710975
ANTHEM PTAN
IN
05
—
200996710
—
IN
01
—
P01054236
RAILROAD MEDICARE
IN
Enumeration date
07/28/2010
Last updated
02/14/2025
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