Provider Demographics
NPI:1225266091
Name:VERGARA, ERIN NEHUS (DPT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:NEHUS
Last Name:VERGARA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:NEHUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:5216 JERRY CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-3770
Mailing Address - Country:US
Mailing Address - Phone:317-919-2588
Mailing Address - Fax:
Practice Address - Street 1:9757 WESTPOINT DR
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3341
Practice Address - Country:US
Practice Address - Phone:317-845-5400
Practice Address - Fax:317-713-1211
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009608A2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic