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NPI Code Detail

MEDICARE: ANGELA RENA WITZMANN CNS/APRN

MEDICARE: ANGELA RENA WITZMANN CNS/APRN
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
1364SP0808XPsychiatric/Mental Health Clinical Nurse Specialist70000076AIN
2363LP0808XPsychiatric/Mental Health Nurse Practitioner70000076AIN
3163WP0808XPsychiatric/Mental Health Registered Nurse28110617AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000335051OTHERINANTHEM PIN NUMBER

General Provider Information

NPI Number : 1215971833
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA RENA WITZMANN CNS/APRN
Provider Business Mailing Address
First Line : 3403 E RAYMOND ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46203-4744
Country : US
Telephone Number : 317-957-2000
Fax Number : 317-957-2050
Provider Business Practice Location Address
First Line : 1522 W MORRIS ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46221-1629
Country : US
Telephone Number : 317-957-2500
Fax Number : 317-957-2520
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 11/27/2017

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