MEDICARE: INDIRA INABATHINI

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	363LF0000X	Family Nurse Practitioner	A173974	IA

General Provider Information

NPI Number	:	1407544687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INDIRA INABATHINI

Provider Business Mailing Address
First Line	:	9000 WOODED POINT DR
Second Line	:
City	:	JOHNSTON
State	:	IA
Zip	:	50131-4742
Country	:	US
Telephone Number	:	520-245-6991
Fax Number	:

Provider Business Practice Location Address
First Line	:	9000 WOODED POINT DR
Second Line	:
City	:	JOHNSTON
State	:	IA
Zip	:	50131-4742
Country	:	US
Telephone Number	:	520-245-6991
Fax Number	:

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

Provider Enumeration Date	:	04/26/2023
Last Update Date	:	06/08/2026

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Directions to “ INDIRA INABATHINI ” Practice Location

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