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Individual

PAMELA SUE ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP-BC

Contact information

Practice address
8433 HARCOURT RD STE 100, INDIANAPOLIS, IN 46260-2193
(317) 583-7600
Mailing address
8433 HARCOURT RD STE 100, INDIANAPOLIS, IN 46260-2193

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71002545A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71002545A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201023490
IN
Enumeration date
02/22/2010
Last updated
05/18/2022
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