Individual
AUTUMN J AGBAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
6002 E 38TH ST, INDIANAPOLIS, IN 46226-5614
(317) 880-6002
(317) 880-0417
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
21220818A
IN
363LF0000X
Family Nurse Practitioner
Primary
71012160A
IN
Other
Enumeration date
01/06/2022
Last updated
11/25/2025
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