Provider Demographics
NPI:1689903916
Name:VRABEL, LEEANN HUGHES (PA-C)
Entity Type:Individual
Prefix:
First Name:LEEANN
Middle Name:HUGHES
Last Name:VRABEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LEEANN
Other - Middle Name:LYNN
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:317-963-0860
Mailing Address - Fax:317-962-4343
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:317-963-1950
Practice Address - Fax:317-963-1955
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1415363A00000X
IN10001634A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN194850004Medicare PIN
IN264430193Medicare PIN