Healthcare Provider Details

I. General information

NPI: 1487575858
Provider Name (Legal Business Name): EMMI JANE MONANA NGITNGIT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 UNIVERSITY BLVD
INDIANAPOLIS IN
46202-5149
US

IV. Provider business mailing address

742 BLAKE ST APT A
INDIANAPOLIS IN
46202-2972
US

V. Phone/Fax

Practice location:
  • Phone: 317-222-9633
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28284514A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: