Healthcare Provider Details

I. General information

NPI: 1972138618
Provider Name (Legal Business Name): INDIANA UNIVERSITY HEALTH ARNETT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1327 VETERANS MEMORIAL PKWY E
LAFAYETTE IN
47905-8917
US

IV. Provider business mailing address

1200 W WHITE RIVER BLVD ATTN: PROVIDER ENROLLMENT
MUNCIE IN
47303-4988
US

V. Phone/Fax

Practice location:
  • Phone: 765-838-5464
  • Fax:
Mailing address:
  • Phone: 765-282-8900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: DANIEL E NEUFELDER
Title or Position: PRESIDENT
Credential:
Phone: 765-838-6212