Provider Demographics
NPI:1487708715
Name:WILLET, ANNE M (FNP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:WILLET
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:M
Other - Last Name:SKAIFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8931 E 30TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-1501
Mailing Address - Country:US
Mailing Address - Phone:317-355-9320
Mailing Address - Fax:317-621-9319
Practice Address - Street 1:8931 E 30TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-1501
Practice Address - Country:US
Practice Address - Phone:317-355-9320
Practice Address - Fax:317-621-9319
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003207A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000660008OtherANTHEM
IN200981100Medicaid
IN000000660008OtherANTHEM