Healthcare Provider Details

I. General information

NPI: 1487251930
Provider Name (Legal Business Name): ELIZABETH COULSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N ILLINOIS ST STE 110
INDIANAPOLIS IN
46204-4293
US

IV. Provider business mailing address

9 MUNICIPAL DR UNIT 214
FISHERS IN
46038-1622
US

V. Phone/Fax

Practice location:
  • Phone: 317-948-6161
  • Fax:
Mailing address:
  • Phone: 217-251-8182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71014182A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR45510
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: