Individual
MS. BEVERLY JEAN VANNATTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 554-0000
Mailing address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 554-0000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28087567A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71002357A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000639911
BC/BS
IN
01
—
000000659920
ANTHEM BC/BS
IN
05
—
200964800A
—
IN
01
—
P00775277
RAILROAD MEDICARE
IN
01
—
P00841090
RAILROAD MEDICARE
IN
Enumeration date
02/16/2007
Last updated
06/29/2011
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