Laura J. Shade
Nurse Practitioner - Neonatal
705 Riley Hospital Dr Rr 208
Indianapolis
, Indiana 46202-5109
Laura J. Shade
Nurse Practitioner - Neonatal
705 Riley Hospital Dr Rr 208
Indianapolis
, Indiana 46202-5109
(317) 278-9905
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About
Features
Specialties
- Nurse Practitioner - Neonatal
Languages spoken
- English
Location
First Address
- Laura J. Shade
- Po Box 1026
- Indianapolis, IN
- Zip : 46206-1026
- Fax : (317) 278-9905
- Phone : (317) 274-1201
Second Address
- Laura J. Shade
- 705 Riley Hospital Dr Rr 208
- Indianapolis, IN
- Zip : 46202-5109
- Fax : (317) 274-2065
- Phone : (317) 274-4715
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 363LN0000X | Nurse Practitioner - Neonatal | 28193093 | IN |
| Y | 363LN0000X | Nurse Practitioner - Neonatal | 71004167 | IN |
National Provider Identifier
| NPI | 1083915201 |
|---|---|
| Provider Name | Laura J. Shade |
| First Address | Indianapolis, IN 46206-1026 |
| Second Address | Indianapolis, IN 46202-5109 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/11/2010 |
| Last Update Date | 17/04/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 201005360 | (05) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.