Healthcare Provider Details

I. General information

NPI: 1346950565
Provider Name (Legal Business Name): WORKPLACE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2022
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6220 INWOOD DR
COLUMBUS IN
47201-2829
US

IV. Provider business mailing address

950 N MERIDIAN ST
INDIANAPOLIS IN
46204-1077
US

V. Phone/Fax

Practice location:
  • Phone: 812-373-6488
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LEAH MARIE BERGMAN
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 317-963-1612