Individual
HEATHER STULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1402 E COUNTY LINE RD, INDIANAPOLIS, IN 46227-0963
(317) 621-5700
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000754A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201292730
—
IN
01
—
P01512441
RR MEDICARE
IN
Enumeration date
06/05/2006
Last updated
05/10/2022
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