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General NPI Number Information
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NPI Number | 1376023739
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Entity Type | Individual
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Provider Name | ELAINE NICOLE PURDUE NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/15/2018
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 8424 NAAB RD STE 2A
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1966
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Country | US
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Telephone | 317-415-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 5216 E 71ST ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-3886
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Country | US
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Telephone | 317-507-4451
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 28211192A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28211192A
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License Number State | IN
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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 | 71008220A
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License Number State | IN
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