Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 71005139A | IN |
NPI | 1003217753 |
---|---|
Provider Name | Mrs. Heather M Caul |
First Address | Indianapolis, IN 46260-1902 |
Second Address | Carmel, IN 46032-3318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2014 |
Last Update Date | 29/10/2021 |