Individual
NATALIE RAE DEBURGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
550 UNIVERSITY BLVD # UH0279, INDIANAPOLIS, IN 46202-5149
(317) 274-0275
(317) 274-0256
Mailing address
550 UNIVERSITY BLVD # UH0279, INDIANAPOLIS, IN 46202-5149
(317) 274-0275
(317) 274-0256
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
75000021A
IN
367H00000X
Anesthesiologist Assistant
8152
GA
367H00000X
Anesthesiologist Assistant
Primary
ANT.0000095
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
095200022
MEDICARE PTAN
IN
01
—
266430697
MEDICARE PTAN
IN
Enumeration date
11/01/2016
Last updated
12/20/2023
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