Provider Demographics
NPI:1821785387
Name:SCHOETTLE, CASEY MARIE (NP)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:MARIE
Last Name:SCHOETTLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-1238
Mailing Address - Country:US
Mailing Address - Phone:317-374-0919
Mailing Address - Fax:
Practice Address - Street 1:11700 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4656
Practice Address - Country:US
Practice Address - Phone:317-688-5840
Practice Address - Fax:317-962-3916
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28223805A163WC0200X
IN71014110A363LG0600X, 363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN074790153OtherMEDICARE PTAN
IN1103157452OtherANTHEM PTAN
IN267030324OtherMEDICARE PTAN
IN300079156Medicaid