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General NPI Number Information
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NPI Number | 1336231133
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Entity Type | Individual
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Provider Name | THERESA KAY MENNER NP
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 08/20/2010
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Provider Practice Location Address
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Address Line | 8244 E. US 36 STE. 1100, HENDRICKS REGIONAL HEALTH IMMEDIATE CARE
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City | AVON
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State | IN
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Zip | 46123-9627
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Country | US
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Telephone | 317-272-7500
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Fax | 317-272-7515
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Provider Business Mailing Address
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Address Line | 34 W 59TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46208-1513
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Country | US
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Telephone | 317-257-2636
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 70000199A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 70000199A
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License Number State | IN
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