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NPI Code Detail

MEDICARE: CHANEL SIMONE TROTTER FNP-C

MEDICARE: CHANEL SIMONE TROTTER FNP-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
1363LF0000XFamily Nurse Practitioner71011537AIN

General Provider Information

NPI Number : 1881362788
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANEL SIMONE TROTTER FNP-C
Provider Business Mailing Address
First Line : 794 CAROLINA WAY
Second Line :
City : AVON
State : IN
Zip : 46123-6525
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2868 N PENNSYLVANIA ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-4125
Country : US
Telephone Number : 317-221-3400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2021
Last Update Date : 09/04/2021

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Directions to “ CHANEL SIMONE TROTTER FNP-C” Practice Location

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