Provider Demographics
NPI:1104131515
Name:WILCHER, TONI LYNN (APN-BC)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:LYNN
Last Name:WILCHER
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12130 E WASHINGTON ST STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-2955
Practice Address - Country:US
Practice Address - Phone:317-355-7752
Practice Address - Fax:317-355-7750
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003313A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201009410Medicaid
INQ00416551OtherRAILROAD MEDICARE
INM400029018Medicare PIN
INM400029016Medicare PIN
INM400038068Medicare PIN
IN201009410Medicaid
INM400029015Medicare PIN
INM400029017Medicare PIN
INM400029014Medicare PIN