Healthcare Provider Details

I. General information

NPI: 1588575542
Provider Name (Legal Business Name): SEASIDE PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13859 GATSBY DR
FISHERS IN
46038-8406
US

IV. Provider business mailing address

13859 GATSBY DR
FISHERS IN
46038-8406
US

V. Phone/Fax

Practice location:
  • Phone: 239-300-5976
  • Fax:
Mailing address:
  • Phone: 239-300-5976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TULSY SADLER
Title or Position: OWNER / FAMILY NURSE PRACTITIONER
Credential: FNP-C
Phone: 239-300-5976