Healthcare Provider Details

I. General information

NPI: 1942058862
Provider Name (Legal Business Name): RILEY ELIZABETH SEXSON MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8402 HARCOURT RD STE 731
INDIANAPOLIS IN
46260-2056
US

IV. Provider business mailing address

8402 HARCOURT RD STE 731
INDIANAPOLIS IN
46260-2056
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-6815
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number28230526A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number71015344A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: