Healthcare Provider Details

I. General information

NPI: 1649721267
Provider Name (Legal Business Name): ADVANCED HEALTH INITIATIVES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 E WABASH ST
FRANKFORT IN
46041-2750
US

IV. Provider business mailing address

1805 E WABASH ST
FRANKFORT IN
46041-2750
US

V. Phone/Fax

Practice location:
  • Phone: 317-946-9929
  • Fax: 888-846-1033
Mailing address:
  • Phone: 317-946-9929
  • Fax: 888-846-1033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. DUANE SNIDER
Title or Position: MBR
Credential:
Phone: 317-946-9929