Provider Demographics
NPI:1427066281
Name:PATRICK, ANNE (NP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:PATRICK
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:950 N MERIDIAN ST
Mailing Address - Street 2:STE 500 PROVIDER ENROLLMENT
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-3908
Mailing Address - Country:US
Mailing Address - Phone:317-962-4941
Mailing Address - Fax:317-962-4950
Practice Address - Street 1:1701 N SENATE BLVD
Practice Address - Street 2:RM AG 001
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1239
Practice Address - Country:US
Practice Address - Phone:317-962-3886
Practice Address - Fax:317-962-8652
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2010-11-19
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Provider Licenses
StateLicense IDTaxonomies
IN71000698363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200221870Medicaid
INP42978Medicare UPIN
IN200221870Medicaid
IN264430ZZZMedicare PIN