Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 01078682A | IN |
N | 207V00000X | Obstetrician & Gynecologist | ML60156663 | WA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 01078682A | IN |
NPI | 1154647220 |
---|---|
Provider Name | Caroline Elizabeth Rouse |
First Address | Indianapolis, IN 46202 |
Second Address | Indianapolis, IN 46202-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2010 |
Last Update Date | 05/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300005054 | (05) | IN |
896330036 | MEDICARE PTAN (01) | IN |