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NPI Code Detail

MEDICARE: TANYA S MASSEY ARNP

MEDICARE: TANYA S MASSEY ARNP
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
1363L00000XNurse Practitioner71004573AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000358295OTHERKYANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891791513
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANYA S MASSEY ARNP
Provider Business Mailing Address
First Line : 10330 N MERIDIAN ST
Second Line : SUITE 201
City : INDIANAPOLIS
State : IN
Zip : 46290-1024
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2001 W 86TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-1902
Country : US
Telephone Number : 317-338-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 02/11/2014

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Directions to “ TANYA S MASSEY ARNP” Practice Location

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