Healthcare Provider Details

I. General information

NPI: 1174997399
Provider Name (Legal Business Name): HEATHER C LENTS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2015
Last Update Date: 11/27/2023
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8177 CLEARVISTA PKWY STE 100
INDIANAPOLIS IN
46256-1662
US

IV. Provider business mailing address

4903 S EMERSON AVE
INDIANAPOLIS IN
46203-5938
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-7800
  • Fax:
Mailing address:
  • Phone: 317-786-7950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28180081A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71006119A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: