Individual
TANYA S MASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-1111
Mailing address
10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71004573A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000358295
ANTHEM
KY
05
—
78013661
—
KY
Enumeration date
06/27/2005
Last updated
02/11/2014
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