Provider Demographics
NPI:1508581414
Name:JOSEPH, INDIA
Entity Type:Individual
Prefix:MS
First Name:INDIA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5845 SUNNYSIDE RD STE 800
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-8404
Mailing Address - Country:US
Mailing Address - Phone:317-222-8854
Mailing Address - Fax:
Practice Address - Street 1:5845 SUNNYSIDE RD STE 800
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-8404
Practice Address - Country:US
Practice Address - Phone:317-222-8854
Practice Address - Fax:317-483-0455
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-04
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300065782Medicaid