Individual
REBECCA G HAVIZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1801 N SENATE BLVD MPC2#3300, INDIANAPOLIS, IN 46202-1228
(317) 923-1787
(317) 962-0262
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001454A
IN
363AS0400X
Surgical Physician Assistant
10001454A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300005443
—
IN
Enumeration date
04/08/2013
Last updated
05/22/2025
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