MEDICARE: LANA SUE MCKAY NP-C

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	28092213A	IN

General Provider Information

NPI Number	:	1922447796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANA SUE MCKAY NP-C

Provider Business Mailing Address
First Line	:	893 S DELAWARE ST
Second Line	:	LILLY CORPORATE CENTER
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46225-1782
Country	:	US
Telephone Number	:	317-433-1749
Fax Number	:	317-276-1733

Provider Business Practice Location Address
First Line	:	893 S DELAWARE ST
Second Line	:	LILLY CORPORATE CENTER
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46225-1782
Country	:	US
Telephone Number	:	317-433-1749
Fax Number	:	317-276-1733

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

Provider Enumeration Date	:	06/14/2013
Last Update Date	:	06/14/2013

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