Basic Information
| Provider Information | |||||||||
| NPI: | 1568954857 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CATANESE | ||||||||
| FirstName: | GINA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | MSN, APN, FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6626 E 75TH ST STE 500 | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462502890 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176219312 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 N RITTER AVE STE 375 | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 46219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173559370 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2018 | ||||||||
| LastUpdateDate: | 10/31/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 28207036A | IN | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 28207036A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 300015609 | 05 | IN | MEDICAID | 266180B81 | 01 | IN | MEDICARE | OTHER | P02085829 | 01 | IN | RAILROAD MEDICARE | OTHER |