Provider Demographics
NPI:1316997547
Name:EOFF, MARY J (NP)
Entity type:Individual
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First Name:MARY
Middle Name:J
Last Name:EOFF
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1120 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5135
Mailing Address - Country:US
Mailing Address - Phone:317-274-0273
Mailing Address - Fax:317-567-2191
Practice Address - Street 1:550 UNIVERSITY BLVD
Practice Address - Street 2:STE. 2115
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5149
Practice Address - Country:US
Practice Address - Phone:317-274-2891
Practice Address - Fax:317-567-2191
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2007-08-07
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Provider Licenses
StateLicense IDTaxonomies
IN71000967364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
INQ61179Medicare UPIN