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NPI Code Detail

MEDICARE: NICOLE RENEE CARDER RT (R)

MEDICARE: NICOLE RENEE CARDER RT (R)
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
12471C3402XRadiography Radiologic Technologist439279IN

General Provider Information

NPI Number : 1578729760
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE RENEE CARDER RT (R)
Provider Business Mailing Address
First Line : 1481 W 10TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2803
Country : US
Telephone Number : 317-988-2528
Fax Number :
Provider Business Practice Location Address
First Line : 1481 W 10TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2803
Country : US
Telephone Number : 317-988-2528
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2008
Last Update Date : 08/06/2008

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Directions to “ NICOLE RENEE CARDER RT (R)” Practice Location

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