Healthcare Provider Details

I. General information

NPI: 1225310147
Provider Name (Legal Business Name): NANCY MENNING ANP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2011
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8111 S EMERSON AVE SUITE 204
INDIANAPOLIS IN
46237-8601
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-528-2555
  • Fax: 317-528-2566
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number71003350A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71003350A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: