Provider Demographics
NPI:1932144656
Name:LE, CATHERINE ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:LE
Suffix:
Gender:F
Credentials:PA-C
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 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 1:1400 N. RITTER AVENUE,
Practice Address - Street 2:SUITE 370
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-3098
Practice Address - Country:US
Practice Address - Phone:317-355-1144
Practice Address - Fax:317-355-1155
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10000743A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP01170032OtherRR MEDICARE PTAN
IN300007571Medicaid
INP01170032OtherRR MEDICARE PTAN