MEDICARE: SARAH L KEPPEL NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	71005768A	IN

General Provider Information

NPI Number	:	1104294636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH L KEPPEL NP

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 N CAPITOL AVE
Second Line	:	B239
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-1203
Country	:	US
Telephone Number	:	317-963-1400
Fax Number	:	317-963-1453

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2015
Last Update Date	:	02/05/2021

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