Individual
THADDEUS HERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1402 E COUNTY LINE RD, INDIANAPOLIS, IN 46227-0963
(317) 887-7957
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7547
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
28155396
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
28155396A
IN
367500000X
Certified Registered Nurse Anesthetist
APRN.CRNA.019435
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200431170
—
IN
Enumeration date
05/16/2006
Last updated
06/05/2024
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