Healthcare Provider Details

I. General information

NPI: 1154930626
Provider Name (Legal Business Name): ANNA CHRISTINE HIMES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA ROSS

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 S STATE ROAD 135 STE 310
GREENWOOD IN
46143-5527
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-497-2400
  • Fax: 317-497-2515
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71010210A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71010210A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: