Provider Demographics
NPI:1376653014
Name:HAWEIT, MICHELLE (NP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:HAWEIT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:M
Other - Last Name:SELEYMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13100 E 136TH ST
Practice Address - Street 2:SUITE 3600
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9822
Practice Address - Country:US
Practice Address - Phone:317-678-3777
Practice Address - Fax:317-678-3770
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002076A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN068010363OtherMEDICARE PTAN
IN200907320Medicaid
INP01347709OtherMEDICARE RR PTAN
IN000000384547OtherANTHEM PIN
IN267030017OtherMEDICARE PTAN
IN076330HHMedicare PIN
IN000000384547OtherANTHEM PIN