Individual
PALLAVI REDDY MUDDASANI BHASYAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
299 E PENDLETON AVE # 547, LAPEL, IN 46051-5546
(765) 534-3636
(765) 534-3638
Mailing address
12286 WHISPERING BREEZE DR, FISHERS, IN 46037-4452
(765) 609-0506
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71013615A
IN
363LP2300X
Primary Care Nurse Practitioner
28254959A
IN
Other
Enumeration date
02/07/2023
Last updated
04/03/2024
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