Healthcare Provider Details

I. General information

NPI: 1679409726
Provider Name (Legal Business Name): SASSAFRAS HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7950 N SHADELAND AVE STE 350
INDIANAPOLIS IN
46250-2699
US

IV. Provider business mailing address

7950 N SHADELAND AVE STE 350
INDIANAPOLIS IN
46250-2699
US

V. Phone/Fax

Practice location:
  • Phone: 317-437-3681
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: ANGELA LYTTLE
Title or Position: OWNER
Credential: MSN, RN, CNM
Phone: 260-615-2529