Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 08002093A | IN |
NPI | 1295948735 |
---|---|
Provider Name | Dr. Stacie J. Macari |
First Address | Carmel, IN 46032-2995 |
Second Address | Carmel, IN 46032-2995 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U80872 | (02) | IN |