Provider Demographics
NPI:1568775153
Name:DELAMBO, BETH MARIE (CNS APN)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:MARIE
Last Name:DELAMBO
Suffix:
Gender:F
Credentials:CNS APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6950 HILLSDALE CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2040
Practice Address - Country:US
Practice Address - Phone:317-621-7740
Practice Address - Fax:317-621-7608
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003277A364SP0808X, 364SP0810X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No364SP0810XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Family
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000669951OtherANTHEM BCBS
IN000000822127OtherANTHEM BCBS
IN000000822111OtherANTHEM BCBS
IN201026950Medicaid