MEDICARE: MYLINDA JORAE CRIPE NP-C

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	71002799A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01291550	OTHER	IN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	000000594941	OTHER	IN	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497990600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYLINDA JORAE CRIPE NP-C

Provider Business Mailing Address
First Line	:	6626 E 75TH ST
Second Line	:	SUITE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2890
Country	:	US
Telephone Number	:	317-621-3684
Fax Number	:	317-621-3689

Provider Business Practice Location Address
First Line	:	1095 BROAD RIPPLE AVE
Second Line	:	SUITE A
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-2034
Country	:	US
Telephone Number	:	317-621-3680
Fax Number	:	317-621-3689

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

Provider Enumeration Date	:	12/03/2008
Last Update Date	:	11/27/2023

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Directions to “ MYLINDA JORAE CRIPE NP-C” Practice Location

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