Provider Demographics
NPI:1528408028
Name:STADLER, TRICIA J (NP)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:J
Last Name:STADLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:J
Other - Last Name:LOY KRITIKOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8890 E 116TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2820
Practice Address - Country:US
Practice Address - Phone:317-621-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004534A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201174600Medicaid
IN201174600Medicaid