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ALLISON ELISE CHURCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
11590 N MERIDIAN ST STE 300, CARMEL, IN 46032-4529
(317) 948-7450
(317) 688-5098
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003634A
IN
363A00000X
Physician Assistant
5601008132
MI
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1102298260
ANTHEM PTAN
IN
05
300067817
IN
Enumeration date
03/23/2015
Last updated
02/10/2025
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