Healthcare Provider Details

I. General information

NPI: 1538086350
Provider Name (Legal Business Name): CIRCLE CITY EXPRESS AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7411 HEATHROW WAY
INDIANAPOLIS IN
46241-9525
US

IV. Provider business mailing address

7411 HEATHROW WAY
INDIANAPOLIS IN
46241-9525
US

V. Phone/Fax

Practice location:
  • Phone: 317-852-3505
  • Fax:
Mailing address:
  • Phone: 317-852-3505
  • Fax: 317-893-3053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KYRA COOKE
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 317-852-3505