Provider Demographics
NPI:1427078526
Name:HORAN-TOLL NP, SANDRA K (NP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:HORAN-TOLL NP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:K
Other - Last Name:HORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-355-2184
Mailing Address - Fax:317-355-2185
Practice Address - Street 1:10122 E 10TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-2664
Practice Address - Country:US
Practice Address - Phone:317-355-2200
Practice Address - Fax:317-355-2185
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000114A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200160280Medicaid
INM400043109Medicare PIN
INH09690Medicare UPIN
IN213810DMedicare PIN