Individual
ANGELA MARIE HERTENSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
282 N BELLEVIEW PL, INDIANAPOLIS, IN 46222-4148
(317) 213-0230
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
28254197A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71015208A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104198243
ANTHEM PTAN
IN
05
—
300093992
—
IN
Enumeration date
01/15/2024
Last updated
12/13/2024
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