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General NPI Number Information
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NPI Number | 1396437141
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Entity Type | Organization
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Legal Business Name | SERVANT EXPRESS CARE, LLC
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 2346 S LYNHURST DR STE E107
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City | INDIANAPOLIS
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State | IN
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Zip | 46241-5169
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Country | US
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Telephone | 317-688-8061
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Fax | 317-688-8064
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Provider Business Mailing Address
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Address Line | 2346 S LYNHURST DR STE E109
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City | INDIANAPOLIS
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State | IN
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Zip | 46241-5169
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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 | MEMBER
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Name | DUANESHA POTTER
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Credential | NP
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Telephone | 317-480-0415
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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