Healthcare Provider Details

I. General information

NPI: 1114788080
Provider Name (Legal Business Name): CALEY E BENDER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2024
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3524 N MERIDIAN ST
INDIANAPOLIS IN
46208-4486
US

IV. Provider business mailing address

12890 OLD MERIDIAN ST APT 364
CARMEL IN
46032-8935
US

V. Phone/Fax

Practice location:
  • Phone: 317-925-0653
  • Fax:
Mailing address:
  • Phone: 765-430-0632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71014879A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: