MEDICARE: ELIZABETH L LAW 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	363LA2200X	Adult Health Nurse Practitioner	71002664A	IN
2	363LA2200X	Adult Health Nurse Practitioner	5734P	KY

General Provider Information

NPI Number	:	1558521815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH L LAW NP-C

Provider Business Mailing Address
First Line	:	7340 SHADELAND STA STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-3980
Country	:	US
Telephone Number	:	317-806-8260
Fax Number	:	317-806-8296

Provider Business Practice Location Address
First Line	:	7340 SHADELAND STA STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-3980
Country	:	US
Telephone Number	:	317-806-8260
Fax Number	:	317-806-8296

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

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	08/16/2012

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