Healthcare Provider Details

I. General information

NPI: 1811066657
Provider Name (Legal Business Name): LORELLA NARDINI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 N RITTER AVE
INDIANAPOLIS IN
46219-3026
US

IV. Provider business mailing address

6950 HILLSDALE CT ATTN CAROL GORBETT
INDIANAPOLIS IN
46250-2040
US

V. Phone/Fax

Practice location:
  • Phone: 317-322-4095
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: