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General NPI Number Information
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NPI Number | 1598716524
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Entity Type | Organization
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Legal Business Name | MINDGENT HEALTHCARE CLINICS, LLC
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10401 N MERIDIAN ST SUITE 310
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City | INDIANAPOLIS
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State | IN
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Zip | 46290-1151
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Country | US
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Telephone | 317-428-4379
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Fax | 317-574-0336
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Provider Business Mailing Address
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Address Line | 10401 NORTH MERIDIAN STREET SUITE 310
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City | INDIANAPOLIS
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State | IN
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Zip | 46290-1151
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Country | US
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Telephone | 317-428-4379
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Fax | 317-574-0336
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MS. JULIE BECKNER
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Credential |
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Telephone | 317-428-4370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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