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General NPI Number Information
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NPI Number | 1114464575
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Entity Type | Individual
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Provider Name | ABIGAIL G BORIS APRN
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Gender | Female
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Dates
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Enumeration Date | 01/24/2017
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Last Update Date | 08/02/2018
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Provider Practice Location Address
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Address Line | 3834 S EMERSON AVE BLDG C STE 100
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City | INDIANAPOLIS
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State | IN
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Zip | 46203
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Country | US
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Telephone | 317-782-1577
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Fax | 888-366-7577
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Provider Business Mailing Address
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Address Line | PO BOX 3299
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City | CARSON CITY
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State | NV
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Zip | 89702-3299
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Country | US
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Telephone | 775-222-0044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28191010A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 71007760A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 71007760A
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License Number State | IN
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