Healthcare Provider Details

I. General information

NPI: 1215540281
Provider Name (Legal Business Name): ELIZABETH SIGLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 LAFAYETTE RD
INDIANAPOLIS IN
46222-1146
US

IV. Provider business mailing address

10200 S 575 W
FORTVILLE IN
46040-9221
US

V. Phone/Fax

Practice location:
  • Phone: 317-291-7422
  • Fax:
Mailing address:
  • Phone: 317-670-9371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number28241962A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71011850A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: