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General NPI Number Information
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NPI Number | 1033737069
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Entity Type | Organization
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Legal Business Name | HOUSECALLS/OPTUM FOR UNITED HEALTH GROUP
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Dates
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Enumeration Date | 07/07/2020
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 518 EUCLID AVE
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City | GREENWOOD
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State | IN
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Zip | 46142-3618
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Country | US
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Telephone | 317-552-5531
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Fax |
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Provider Business Mailing Address
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Address Line | 9900 BREN RD E
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City | MINNETONKA
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State | MN
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Zip | 55343-9664
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NP
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Name | ELAINE CHANCE
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Credential | FNP
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Telephone | 317-882-5531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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