Healthcare Provider Details

I. General information

NPI: 1265223424
Provider Name (Legal Business Name): MINDY KNAPP PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MINDY BLAZEK PHARMD

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 W 16TH ST STE 5400
INDIANAPOLIS IN
46202-2393
US

IV. Provider business mailing address

355 W 16TH ST STE 5400
INDIANAPOLIS IN
46202-2393
US

V. Phone/Fax

Practice location:
  • Phone: 317-963-7248
  • Fax: 317-963-7234
Mailing address:
  • Phone: 317-963-7248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number26019988A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: