Provider Demographics
NPI:1326129107
Name:HERBER, ILONKA WILHELMINE (RN, CNM)
Entity Type:Individual
Prefix:MRS
First Name:ILONKA
Middle Name:WILHELMINE
Last Name:HERBER
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6703 N EWING ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-3750
Mailing Address - Country:US
Mailing Address - Phone:317-259-1816
Mailing Address - Fax:317-259-1816
Practice Address - Street 1:200 S MERIDIAN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46225-1055
Practice Address - Country:US
Practice Address - Phone:317-637-4343
Practice Address - Fax:317-637-4344
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN09000016A367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife