Healthcare Provider Details

I. General information

NPI: 1326453440
Provider Name (Legal Business Name): EMILY ISSETTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 E MAIN ST
PLAINFIELD IN
46168-1859
US

IV. Provider business mailing address

8735 BERGESON DR
INDIANAPOLIS IN
46278-1192
US

V. Phone/Fax

Practice location:
  • Phone: 317-839-5149
  • Fax: 317-838-3500
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26025546A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: