Healthcare Provider Details

I. General information

NPI: 1588673230
Provider Name (Legal Business Name): JANET SMELTZER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5502 E 16TH ST
INDIANAPOLIS IN
46218-4937
US

IV. Provider business mailing address

8180 CLEARVISTA PKWY 230
INDIANAPOLIS IN
46256-5629
US

V. Phone/Fax

Practice location:
  • Phone: 317-355-5394
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number28052398A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: