Individual
DIANA LYNN BANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
11020 PENDLETON PIKE, INDIANAPOLIS, IN 46236-2817
(317) 826-3903
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000732A
IN
Other
Enumeration date
02/15/2007
Last updated
05/08/2017
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