Individual
SHYANNA PETTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3725 BONN BLVD, INDIANAPOLIS, IN 46228-6788
(317) 457-6479
Mailing address
3725 BONN BLVD, INDIANAPOLIS, IN 46228-6788
(317) 457-6479
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
25-019673
IN
Other
Enumeration date
01/05/2026
Last updated
01/05/2026
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