Healthcare Provider Details

I. General information

NPI: 1700228301
Provider Name (Legal Business Name): ANDREA RABADI APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2013
Last Update Date: 11/03/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6291 CAMBRIDGE WAY STE 200
PLAINFIELD IN
46168-7905
US

IV. Provider business mailing address

6291 CAMBRIDGE WAY STE 200
PLAINFIELD IN
46168-7905
US

V. Phone/Fax

Practice location:
  • Phone: 317-718-8436
  • Fax:
Mailing address:
  • Phone: 317-718-8436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71004431A
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier000000828498
Identifier TypeOTHER
Identifier StateIN
Identifier IssuerANTHEM BCBS
# 2
Identifier201174730
Identifier TypeMEDICAID
Identifier StateIN
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: