Provider Demographics
NPI:1134376395
Name:ZIEGLER, ADAM (CRNA)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:ZIEGLER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8051 S EMERSON AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8635
Mailing Address - Country:US
Mailing Address - Phone:317-865-2955
Mailing Address - Fax:
Practice Address - Street 1:8051 S EMERSON AVE STE 150
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8635
Practice Address - Country:US
Practice Address - Phone:317-865-2955
Practice Address - Fax:317-865-2954
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28141017A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201046870Medicaid
IL0533210001Medicare NSC
IL901280001Medicare PIN
IL6447860011Medicare NSC