Individual
NATALIE R STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
720 ESKENAZI AVE FL 6, INDIANAPOLIS, IN 46202-5189
(317) 880-6600
(317) 968-1152
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71005218A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71005218A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000904891
ANTHEM
IN
05
—
201263740
—
IN
Enumeration date
10/31/2014
Last updated
12/29/2020
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