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NPI Code Detail

MEDICARE: RACHEL ROEBUCK NP

MEDICARE: RACHEL ROEBUCK 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
1163W00000XRegistered Nurse28225308AIN
2363L00000XNurse Practitioner71012075AIN

General Provider Information

NPI Number : 1366101370
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL ROEBUCK NP
Provider Business Mailing Address
First Line : 6626 E 75TH ST STE 500
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2890
Country : US
Telephone Number : 317-621-1886
Fax Number :
Provider Business Practice Location Address
First Line : 1500 N RITTER AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-3027
Country : US
Telephone Number : 317-355-2246
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2021
Last Update Date : 12/08/2025

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