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Individual

MICHELLE A HANZELY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
9240 N MERIDIAN ST STE 160, INDIANAPOLIS, IN 46260-1827
(317) 574-2286
Mailing address
10330 N MERIDIAN ST # 300, INDIANAPOLIS, IN 46290-1024

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085001934
IL
363A00000X
Physician Assistant
Primary
10001772A
IN
363A00000X
Physician Assistant
10001772B
IN
363AM0700X
Medical Physician Assistant
10001772A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
085001934
IL
Enumeration date
06/15/2007
Last updated
10/04/2016
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