Individual
OLIVIA LYN BEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1111 RONALD REAGAN PKWY, AVON, IN 46123-7085
(317) 217-3500
(317) 217-3551
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71008961A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001273457
ANTHEM PTAN
IN
01
—
000001274222
ANTHEM PTAN
IN
01
—
000001274230
ANTHEM PTAN
IN
01
—
000001615593
ANTHEM PTAN
IN
05
—
300025476
—
IN
Enumeration date
05/14/2019
Last updated
12/09/2024
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