Healthcare Provider Details

I. General information

NPI: 1073329967
Provider Name (Legal Business Name): TARGA HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17784 OAK EDGE CIR
NOBLESVILLE IN
46062-9676
US

IV. Provider business mailing address

17784 OAK EDGE CIR
NOBLESVILLE IN
46062-9676
US

V. Phone/Fax

Practice location:
  • Phone: 317-379-1832
  • Fax:
Mailing address:
  • Phone: 317-379-1832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALEX CLAYTON IRWIN
Title or Position: CEO
Credential: NP
Phone: 317-379-1832