Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 7100132 | IN |
Y | 363L00000X | Nurse Practitioner | 71001132 | IN |
NPI | 1811904790 |
---|---|
Provider Name | Cristina L Ashworth |
First Address | Indianapolis, IN 46202-5112 |
Second Address | Indianapolis, IN 46202-1239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 27/12/2021 |