Basic Information
Provider Information
NPI: 1942569371
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEMAN
FirstName: GINA
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: R.N., FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1100 SOUTHFIELD DR STE 1370
Address2:  
City: PLAINFIELD
State: IN
PostalCode: 461684300
CountryCode: US
TelephoneNumber: 3178375566
FaxNumber: 3178375580
Practice Location
Address1: 1411 S GREEN ST STE 130
Address2:  
City: BROWNSBURG
State: IN
PostalCode: 461122048
CountryCode: US
TelephoneNumber: 3178584610
FaxNumber: 3178384620
Other Information
ProviderEnumerationDate: 05/04/2012
LastUpdateDate: 03/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X28140886AINN Nursing Service ProvidersRegistered Nurse 
363LF0000X71004019AINY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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