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General NPI Number Information
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NPI Number | 1174223788
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Entity Type | Individual
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Provider Name | SARANDA TILLMAN-KEYES
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Gender | Female
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Dates
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Enumeration Date | 03/03/2023
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 220 VIRGINIA AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-3709
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Country | US
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Telephone | 317-238-3534
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Fax |
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Provider Business Mailing Address
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Address Line | 220 VIRGINIA AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-3709
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Country | US
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Telephone | 317-238-3534
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 71013644A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 95036513
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 825642
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0104072-C-NP
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71013644A
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License Number State | IN
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | APN.0104072-C-NP
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License Number State | CO
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Taxonomy #7
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28217140C
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License Number State | IN
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 10036573
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License Number State | OR
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Taxonomy #9
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | AP61677188
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License Number State | WA
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Taxonomy #10
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP61677188
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License Number State | WA
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