Healthcare Provider Details

I. General information

NPI: 1689903916
Provider Name (Legal Business Name): LEEANN HUGHES VRABEL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEEANN LYNN HUGHES PA-C

II. Dates (important events)

Enumeration Date: 12/16/2009
Last Update Date: 01/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 N SENATE BLVD SUITE 535
INDIANAPOLIS IN
46202-1228
US

IV. Provider business mailing address

250 N SHADELAND AVE SUITE 130
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-963-1950
  • Fax: 317-963-1955
Mailing address:
  • Phone: 317-963-0860
  • Fax: 317-962-4343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1415
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10001634A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: