Provider Demographics
NPI:1528264900
Name:BOWEN-BUZARD, SHERRY ELAINE (NP)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:ELAINE
Last Name:BOWEN-BUZARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:ELAINE
Other - Last Name:BOWEN
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:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3850 S EMERSON AVE
Practice Address - Street 2:SUITE C
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-5964
Practice Address - Country:US
Practice Address - Phone:317-355-7700
Practice Address - Fax:317-355-9027
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002414A363LA2200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP01723955OtherRR MEDICARE
IN201385650Medicaid
ININ1697001OtherMEDICARE PTAN
IN266180733Medicare PIN