Healthcare Provider Details

I. General information

NPI: 1619947710
Provider Name (Legal Business Name): ROBIN R ELDIB NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 03/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11495 N PENN ST STE 270
CARMEL IN
46032-5636
US

IV. Provider business mailing address

11495 N PENN ST STE 270
CARMEL IN
46032-5636
US

V. Phone/Fax

Practice location:
  • Phone: 317-938-4559
  • Fax: 317-343-0336
Mailing address:
  • Phone: 317-938-4559
  • Fax: 317-343-0336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71000585A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: