Healthcare Provider Details
I. General information
NPI: 1437118866
Provider Name (Legal Business Name): ILANA HURRLE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/23/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11495 N PENNSYLVANIA ST STE 270
CARMEL IN
46032-5636
US
IV. Provider business mailing address
11495 N PENNSYLVANIA ST STE 270
CARMEL IN
46032-5636
US
V. Phone/Fax
- Phone: 317-938-4559
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 71000219 |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: