Provider Demographics
NPI:1700228301
Name:RABADI, ANDREA (APN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:RABADI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6291 CAMBRIDGE WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-7905
Mailing Address - Country:US
Mailing Address - Phone:317-718-8436
Mailing Address - Fax:
Practice Address - Street 1:6291 CAMBRIDGE WAY STE 200
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-7905
Practice Address - Country:US
Practice Address - Phone:317-718-8436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004431A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000828498OtherANTHEM BCBS
IN201174730Medicaid
IN201174730Medicaid