MEDICARE: CHAD SPERRY APN

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	163WP2201X	Ambulatory Care Registered Nurse	28202586A	IN
2	363LF0000X	Family Nurse Practitioner	71006374A	IN

General Provider Information

NPI Number	:	1720447733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD SPERRY APN

Provider Business Mailing Address
First Line	:	1641 S US HIGHWAY 231
Second Line	:
City	:	CRAWFORDSVILLE
State	:	IN
Zip	:	47933-9421
Country	:	US
Telephone Number	:	765-307-7146
Fax Number	:	765-307-7260

Provider Business Practice Location Address
First Line	:	1130 MOHAWK HILLS DR APT C
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46032-2825
Country	:	US
Telephone Number	:	317-698-7009
Fax Number	:

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

Provider Enumeration Date	:	02/18/2016
Last Update Date	:	03/11/2020

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Directions to “ CHAD SPERRY APN” Practice Location

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