MEDICARE: MRS. BARBARA ANN KOVACS NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	71001620	IN
2	363LF0000X	Family Nurse Practitioner	71001620A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000386020	OTHER	IN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1073695268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARBARA ANN KOVACS NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	6640 PARKDALE PL STE R
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-4698
Country	:	US
Telephone Number	:	317-290-2000
Fax Number	:	317-290-2011

Provider Business Practice Location Address
First Line	:	6640 PARKDALE PL STE R
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-4698
Country	:	US
Telephone Number	:	317-290-2000
Fax Number	:	317-290-2011

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	02/06/2019

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