MEDICARE: AUNDRIANNA WHITESIDE

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	363L00000X	Nurse Practitioner	71009765A	IN

General Provider Information

NPI Number	:	1851923163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUNDRIANNA WHITESIDE

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	844-630-0700
Fax Number	:	877-374-1924

Provider Business Practice Location Address
First Line	:	5115 W WASHINGTON ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46241-2205
Country	:	US
Telephone Number	:	317-799-1268
Fax Number	:	877-965-4298

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

Provider Enumeration Date	:	02/05/2020
Last Update Date	:	02/11/2026

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Directions to “ AUNDRIANNA WHITESIDE ” Practice Location

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