MEDICARE: PRIMROSE WOUND EXPERTS LLC

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1427914019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMROSE WOUND EXPERTS LLC

Provider Business Mailing Address
First Line	:	3302 S EAST ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-1118
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3302 S EAST ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-1118
Country	:	US
Telephone Number	:	317-970-0647
Fax Number	:

Authorized Official
Title or Position	:	ADMIN
Name	:	FLORENCE AMANCHUKWU
Credential	:
Telephone Number	:	317-970-0647

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	12/29/2025

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