Healthcare Provider Details

I. General information

NPI: 1851784094
Provider Name (Legal Business Name): ANDREA OPSAL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2015
Last Update Date: 11/27/2023
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9669 E 146TH ST SUITE 250
NOBLESVILLE IN
46060-5005
US

IV. Provider business mailing address

6626 E 75TH ST STE 500
INDIANAPOLIS IN
46250-2890
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-9926
  • Fax: 317-621-9676
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005383A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: