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NPI Code Detail

MEDICARE: NOEL COURTNEY PUTMAN CRNA

MEDICARE: NOEL COURTNEY PUTMAN CRNA
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
1367500000XCertified Registered Nurse Anesthetist28150634AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000249975OTHERINSIA ANTHEM

General Provider Information

NPI Number : 1346235553
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOEL COURTNEY PUTMAN CRNA
Provider Business Mailing Address
First Line : 8840 COMMERCE PARK PL STE E
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-3129
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 911 N SHELBY ST
Second Line :
City : SALEM
State : IN
Zip : 47167-2304
Country : US
Telephone Number : 812-883-5881
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2005
Last Update Date : 11/21/2014

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Directions to “ NOEL COURTNEY PUTMAN CRNA” Practice Location

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