Basic Information
Provider Information
NPI: 1942587506
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VROBEL
FirstName: ANDREA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2725 HEATHERMOOR PARK DR N
Address2:  
City: CARMEL
State: IN
PostalCode: 460748576
CountryCode: US
TelephoneNumber: 3174661000
FaxNumber: 3174662000
Practice Location
Address1: 4740 KINGSWAY DR
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462051521
CountryCode: US
TelephoneNumber: 3174661000
FaxNumber: 3174662000
Other Information
ProviderEnumerationDate: 11/10/2011
LastUpdateDate: 11/10/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
224Z00000X32000860AINY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant 

No ID Information.


Home