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General NPI Number Information
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NPI Number | 1568688851
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Entity Type | Individual
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Provider Name | CHARLOTTE I GANGWER RN, NP
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7968 PENDLETON PIKE STE B
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City | INDIANAPOLIS
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State | IN
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Zip | 46226-3957
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Country | US
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Telephone | 317-541-8101
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Fax | 317-536-6559
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Provider Business Mailing Address
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Address Line | 9641 KIRK ALLEN DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46235-4781
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Country | US
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Telephone | 317-898-4601
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Fax | 317-536-6559
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 7100118A
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License Number State | IN
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