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General NPI Number Information
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NPI Number | 1134841406
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Entity Type | Individual
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Provider Name | NADEGE MARC NP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 9894 E 121ST ST
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City | FISHERS
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State | IN
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Zip | 46037-4154
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Country | US
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Telephone | 317-621-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 6626 E 75TH ST STE 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2890
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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 |
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AG09220032
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AG09220032
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 71013301A
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License Number State | IN
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