Provider Demographics
NPI:1457675522
Name:ACHENBACH, GRETA S (RN, MSN)
Entity Type:Individual
Prefix:
First Name:GRETA
Middle Name:S
Last Name:ACHENBACH
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:GRETA
Other - Middle Name:S
Other - Last Name:DARLAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN
Mailing Address - Street 1:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1026
Mailing Address - Country:US
Mailing Address - Phone:317-274-1201
Mailing Address - Fax:317-278-9905
Practice Address - Street 1:702 BARNHILL DR
Practice Address - Street 2:ROC 4270
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5128
Practice Address - Country:US
Practice Address - Phone:317-274-7208
Practice Address - Fax:317-274-3442
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28089737163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics