| Iipuc | |
|
1935 N Capitol Ave Indianapolis IN 46202-6403 | |
| (317) 920-1111 | |
| Not Available |
| Full Name | Iipuc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1935 N Capitol Ave, Indianapolis, Indiana |
| Authorized Official Name and Position | Cheryl Graham (DNP) |
| Authorized Official Contact | 4632243210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iipuc Po Box 186 Lebanon IN 46052-0186 Ph: (463) 224-3210 | Iipuc 1935 N Capitol Ave Indianapolis IN 46202-6403 Ph: (317) 920-1111 |
| NPI Number | 1255188587 |
|---|---|
| Provider Enumeration Date | 05/03/2024 |
| Last Update Date | 05/03/2024 |
| Certification Date | 05/03/2024 |
| Medicare PECOS PAC ID | 3173055662 |
|---|---|
| Medicare Enrollment ID | O20241022004367 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255188587 | NPI | - | NPPES |
| Provider Name | Cheryl V Facey-graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730377623 PECOS PAC ID: 0941285365 Enrollment ID: I20040621001053 |
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