Provider Demographics
NPI:1629053293
Name:NWOSU, EVELYN O (RN, MSN, NP-C)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:O
Last Name:NWOSU
Suffix:
Gender:F
Credentials:RN, MSN, NP-C
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Mailing Address - Street 1:8333 NAAB RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5924
Mailing Address - Country:US
Mailing Address - Phone:317-396-1300
Mailing Address - Fax:317-876-4070
Practice Address - Street 1:1801 N SENATE BLVD
Practice Address - Street 2:SUITE 535
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1228
Practice Address - Country:US
Practice Address - Phone:317-396-1300
Practice Address - Fax:317-924-8472
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-07
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN71001900A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN061570BBBMedicare ID - Type Unspecified
INQ34663Medicare UPIN