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General NPI Number Information
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NPI Number | 1336678192
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Entity Type | Individual
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Provider Name | LATOYIA CHERDISE AUSTIN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 2620 E KESSLER BLVD
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-2890
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Country | US
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Telephone | 317-734-6934
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Fax | 312-530-0054
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Provider Business Mailing Address
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Address Line | 2620 E KESSLER BLVD STE 110
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-2889
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Country | US
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Telephone | 317-734-6934
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Fax | 312-530-0054
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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 | 71007215A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number | F0117016
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License Number State | IN
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