Provider Demographics
NPI:1114405008
Name:PEOPLE NURTURING PEOPLE, INC
Entity Type:Organization
Organization Name:PEOPLE NURTURING PEOPLE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:REGENIA
Authorized Official - Last Name:DOWE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:317-924-2484
Mailing Address - Street 1:3640 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-3562
Mailing Address - Country:US
Mailing Address - Phone:317-924-2484
Mailing Address - Fax:
Practice Address - Street 1:3640 WATSON RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-3562
Practice Address - Country:US
Practice Address - Phone:317-924-2484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-01
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100065820Medicaid