Healthcare Provider Details

I. General information

NPI: 1487487161
Provider Name (Legal Business Name): MARIA ROSS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 RILEY HOSPITAL DR
INDIANAPOLIS IN
46202-5109
US

IV. Provider business mailing address

6173 BROADWAY ST
INDIANAPOLIS IN
46220-1834
US

V. Phone/Fax

Practice location:
  • Phone: 317-918-4409
  • Fax:
Mailing address:
  • Phone: 317-918-4409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number28251131A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number71016974A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: