MEDICARE: VANESSA MARIE PRICHARD PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	71013003A	IN

General Provider Information

NPI Number	:	1629798194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA MARIE PRICHARD PMHNP-BC

Provider Business Mailing Address
First Line	:	5311 S ILLINOIS ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46217-3525
Country	:	US
Telephone Number	:	812-361-7553
Fax Number	:

Provider Business Practice Location Address
First Line	:	8920 SOUTHPOINTE DR STE E1
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-7505
Country	:	US
Telephone Number	:	216-468-5000
Fax Number	:

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

Provider Enumeration Date	:	09/02/2022
Last Update Date	:	12/10/2025

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