Basic Information
| Provider Information | |||||||||
| NPI: | 1235559832 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INDIANA INTERNAL MEDICINE CONSULTANTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 E COUNTY LINE RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | GREENWOOD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461431072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178852860 | ||||||||
| FaxNumber: | 3178852869 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 E COUNTY LINE RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | GREENWOOD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461431072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178852860 | ||||||||
| FaxNumber: | 3178852869 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2014 | ||||||||
| LastUpdateDate: | 03/29/2021 | ||||||||
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| AuthorizedOfficialLastName: | SCHIER | ||||||||
| AuthorizedOfficialFirstName: | VALARIE | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRACTICE COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 3178853793 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| NPICertificationDate: | 03/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 28179570A | IN | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.