Individual
GLENDA JACKSON PRABU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13400 N MERIDIAN ST STE 302, CARMEL, IN 46032-7104
(317) 415-6050
Mailing address
13400 N MERIDIAN ST STE 302, CARMEL, IN 46032-7104
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71012779A
IN
363LF0000X
Family Nurse Practitioner
F07211173
IN
Other
Enumeration date
06/17/2022
Last updated
10/08/2024
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