Individual
SARAH L BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1030 W MICHIGAN ST, INDIANAPOLIS, IN 46202-5201
(317) 944-0920
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28187343A
IN
363LA2200X
Adult Health Nurse Practitioner
71005135A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71005135A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000913171
ANTHEM PTAN
IN
05
—
201270630
—
IN
01
—
P01570003
RAILROAD PTAN
IN
Enumeration date
07/30/2014
Last updated
05/14/2025
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