Healthcare Provider Details

I. General information

NPI: 1437524816
Provider Name (Legal Business Name): NOVAPEX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2015
Last Update Date: 12/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2085 ACORN BLVD
FRANKLIN IN
46131-7306
US

IV. Provider business mailing address

2085 ACORN BOULEVARD
FRANKLIN IN
46131
US

V. Phone/Fax

Practice location:
  • Phone: 317-346-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number71005939A
License Number StateIN

VIII. Authorized Official

Name: JILL LAWALIN
Title or Position: NP
Credential:
Phone: 317-346-2273