Provider Demographics
NPI:1851152235
Name:STREICH, ELIZABETH YVONNE (PMHNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:YVONNE
Last Name:STREICH
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BOYD LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-9085
Mailing Address - Country:US
Mailing Address - Phone:781-413-4391
Mailing Address - Fax:
Practice Address - Street 1:1660 N ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-0059
Practice Address - Country:US
Practice Address - Phone:317-880-2900
Practice Address - Fax:317-554-5735
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71012382A363L00000X
IN28239288A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health