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General NPI Number Information
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NPI Number | 1558238345
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Entity Type | Organization
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Legal Business Name | LIFESPAN ADVANCED CARE LLC
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Dates
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Enumeration Date | 10/17/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 118 MEDICAL DR
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City | CARMEL
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State | IN
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Zip | 46032-3323
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Country | US
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Telephone | 317-844-4211
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Fax |
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Provider Business Mailing Address
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Address Line | 11313 USA PKWY STE E148
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City | FISHERS
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State | IN
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Zip | 46037-9208
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Country | US
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Telephone | 317-781-4500
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | MS. LEA ANN RENEE SPENCER
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Credential | APRN
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Telephone | 812-568-1374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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