Healthcare Provider Details

I. General information

NPI: 1427944131
Provider Name (Legal Business Name): MICHELLE DAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 N MERIDIAN ST
INDIANAPOLIS IN
46202-2306
US

IV. Provider business mailing address

1545 N MERIDIAN ST
INDIANAPOLIS IN
46202-2306
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71016914A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: