Healthcare Provider Details

I. General information

NPI: 1659744126
Provider Name (Legal Business Name): LATONYA L SULTZER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2015
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 N ARLINGTON AVE SUITE B
INDIANAPOLIS IN
46218-3361
US

IV. Provider business mailing address

1002 N MITTHOEFER RD STE A
INDIANAPOLIS IN
46229-2461
US

V. Phone/Fax

Practice location:
  • Phone: 317-355-9431
  • Fax: 317-355-9445
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71006098A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number28157480A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: