Basic Information
| Provider Information | |||||||||
| NPI: | 1902210263 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRECELIUS | ||||||||
| FirstName: | TEELA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4831 EAGLES WATCH LN | ||||||||
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| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462549531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122672916 | ||||||||
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| Practice Location | |||||||||
| Address1: | 541 CLINICAL DRIVE, CL 626 | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462025233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172782689 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2014 | ||||||||
| LastUpdateDate: | 12/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 01078480A | IN | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.