Basic Information
| Provider Information | |||||||||
| NPI: | 1255977039 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STROHL | ||||||||
| FirstName: | RENEE | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1503 N MITTHOEFFER RD | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462292425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3179340768 | ||||||||
| FaxNumber: | 3174691658 | ||||||||
| Practice Location | |||||||||
| Address1: | 1315 N ARLINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462193204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4637778686 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2019 | ||||||||
| LastUpdateDate: | 02/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 28209352A | IN | N | Nursing Service Providers | Registered Nurse | 363LP0808X | 71009583A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.