Provider Demographics
NPI:1518394402
Name:GREAT PROVIDER HEALTH SERVICES
Entity Type:Organization
Organization Name:GREAT PROVIDER HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER/NP
Authorized Official - Prefix:DR
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:NARTEY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, FNP-C
Authorized Official - Phone:317-362-9737
Mailing Address - Street 1:662 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-1680
Mailing Address - Country:US
Mailing Address - Phone:317-205-9710
Mailing Address - Fax:317-205-9711
Practice Address - Street 1:4267 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-2409
Practice Address - Country:US
Practice Address - Phone:317-205-9710
Practice Address - Fax:317-205-9711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care