Healthcare Provider Details

I. General information

NPI: 1841131133
Provider Name (Legal Business Name): AMERICAN HEALTH NETWORK OF INDIANA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1192 EDWARDS DRIVE
PLAINFIELD IN
46168
US

IV. Provider business mailing address

1192 EDWARDS DRIVE
PLAINFIELD IN
46168
US

V. Phone/Fax

Practice location:
  • Phone: 317-839-9833
  • Fax: 317-839-7549
Mailing address:
  • Phone: 317-839-9833
  • Fax: 317-839-7549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DENIQUA ADDERLEY
Title or Position: CREDENTIALING
Credential:
Phone: 952-251-0932