Individual
ANNA R MODANSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
701 E COUNTY LINE RD STE 101, GREENWOOD, IN 46143-1070
(317) 885-2860
(317) 885-2869
Mailing address
701 E COUNTY LINE RD STE 101, GREENWOOD, IN 46143-1070
(317) 885-2860
(317) 885-2869
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001279
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300007541
—
IN
Enumeration date
06/14/2011
Last updated
07/24/2023
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