Individual
MRS. STACEY MICHELLE ENGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
821 N STATE ROAD 135, GREENWOOD, IN 46142-1314
(317) 560-4300
(317) 530-9084
Mailing address
821 N STATE ROAD 135, GREENWOOD, IN 46142-1314
(317) 560-4300
(317) 530-9084
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
28180686A
IN
363LG0600X
Gerontology Nurse Practitioner
28180686A
IN
363LP2300X
Primary Care Nurse Practitioner
Primary
28180686A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201253850
—
IN
01
—
P01678705
RR PTAN
IN
Enumeration date
07/15/2014
Last updated
03/30/2019
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