Provider Demographics
NPI:1427527761
Name:HILLER, ANGELA SUE (FNP-C)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:SUE
Last Name:HILLER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12773 PAVESTONE CT
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-3831
Mailing Address - Country:US
Mailing Address - Phone:317-529-3180
Mailing Address - Fax:
Practice Address - Street 1:3915 W MORRIS ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-2619
Practice Address - Country:US
Practice Address - Phone:317-481-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28139841A163WC1600X
IN71009294A363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development