Modleski, Dianne R

Modleski, Dianne R is an individual health care provider with primary practice located at 1633 N Capitol Ave Ste 322, Indianapolis IN 46202-1476. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Modleski, Dianne R can be contacted via phone (317) 962-2929.

Contact Information

Primary practice address
1633 N Capitol Ave Ste 322 Indianapolis IN 46202-1476
Phone: (317) 962-2929
Fax: (317) 962-2070
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71002179A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 71002179A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 71002179A Indiana

Profile Details

NPI number 1679585939
LBN Legal business name Modleski, Dianne R
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated Oct 23rd, 2013 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679585939 NPPES
Indiana MEDICAID 200830870

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