Healthcare Provider Details

I. General information

NPI: 1376653014
Provider Name (Legal Business Name): MICHELLE HAWEIT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE M SELEYMAN NP

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 E 136TH ST SUITE 3600
FISHERS IN
46037-9822
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-678-3777
  • Fax: 317-678-3770
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71002076A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: