Individual
NUR UN NISA NABIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 MEDICAL ARTS BLVD STE 201, ANDERSON, IN 46011-3459
(765) 298-5280
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01084950A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q00369284
RAILROAD MEDICARE
IN
Enumeration date
07/31/2018
Last updated
11/21/2022
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