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Individual

NUNMAWI BUALTENG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5550 S EAST ST STE C, INDIANAPOLIS, IN 46227-1991
(317) 534-4660
Mailing address
8345 SOUTHERN SPRINGS BLVD, INDIANAPOLIS, IN 46237-9289
(317) 752-0113

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71009069A
IN
363LF0000X
Family Nurse Practitioner
Primary
71009069A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300028162
IN
Enumeration date
07/03/2019
Last updated
09/05/2019
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