MEDICARE: ELISSIA UNSELD

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1750180576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISSIA UNSELD

Provider Business Mailing Address
First Line	:	1946 BROCKEN CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-3938
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8426 COUNTRY CLUB BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46234-1848
Country	:	US
Telephone Number	:	317-746-1670
Fax Number	:

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

Provider Enumeration Date	:	03/12/2025
Last Update Date	:	03/12/2025

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Directions to “ ELISSIA UNSELD ” Practice Location

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