Healthcare Provider Details

I. General information

NPI: 1992302517
Provider Name (Legal Business Name): RENEE L HYLKEMA APRN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8326 NAAB RD
INDIANAPOLIS IN
46260-1920
US

IV. Provider business mailing address

8326 NAAB RD
INDIANAPOLIS IN
46260-1920
US

V. Phone/Fax

Practice location:
  • Phone: 317-871-0000
  • Fax: 317-871-0010
Mailing address:
  • Phone: 317-871-0011
  • Fax: 317-870-4552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28161706A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: