Individual
BETH A. PRUSINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
8333 NAAB RD STE 400, INDIANAPOLIS, IN 46260-1992
(317) 338-6666
Mailing address
8840 COMMERCE PARK PL STE E, INDIANAPOLIS, IN 46268-3129
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28082210A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71002871A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200929680
—
IN
Enumeration date
12/02/2008
Last updated
11/17/2014
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