Healthcare Provider Details

I. General information

NPI: 1710348578
Provider Name (Legal Business Name): NATALIE M SPERRY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2016
Last Update Date: 10/04/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9503 E 33RD ST
INDIANAPOLIS IN
46235-4207
US

IV. Provider business mailing address

CARMEL, IN 46032
CARMEL IN
46032
US

V. Phone/Fax

Practice location:
  • Phone: 317-972-7000
  • Fax:
Mailing address:
  • Phone: 317-559-2185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number71006484B
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: