Provider Demographics
NPI:1104552314
Name:BILLUPS, TANSHERICE
Entity type:Individual
Prefix:
First Name:TANSHERICE
Middle Name:
Last Name:BILLUPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2465 N EATON AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-1403
Mailing Address - Country:US
Mailing Address - Phone:317-457-2015
Mailing Address - Fax:
Practice Address - Street 1:2465 N EATON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-1403
Practice Address - Country:US
Practice Address - Phone:317-974-9330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider