Healthcare Provider Details
I. General information
NPI: 1386106847
Provider Name (Legal Business Name): CARE INDY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2019
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2827 SADDLE BARN EAST DR
INDIANAPOLIS IN
46214-1547
US
IV. Provider business mailing address
2827 SADDLE BARN EAST DR
INDIANAPOLIS IN
46214-1547
US
V. Phone/Fax
- Phone: 317-529-2235
- Fax: 862-298-0777
- Phone: 317-529-2235
- Fax: 862-298-0777
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LG0600X |
| Taxonomy | Gerontology Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FINOTE
ASFAW
Title or Position: NP
Credential: NP
Phone: 317-529-2235