Provider Demographics
NPI:1336418003
Name:RODY, DENISE M (NP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:RODY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:M
Other - Last Name:LEGGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:755 WEST CARMEL DR.
Mailing Address - Street 2:STE. 101
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5875
Mailing Address - Country:US
Mailing Address - Phone:317-846-2396
Mailing Address - Fax:317-846-1699
Practice Address - Street 1:755 WEST CARMEL DR.
Practice Address - Street 2:STE. 101
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5875
Practice Address - Country:US
Practice Address - Phone:317-846-2396
Practice Address - Fax:317-846-1699
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000326A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner