Provider Demographics
NPI:1841023025
Name:LOHMAN, ABIGAIL GRACE (PA-C)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:GRACE
Last Name:LOHMAN
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 STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-621-7547
Mailing Address - Fax:
Practice Address - Street 1:1210A MEDICAL ARTS BLVD
Practice Address - Street 2:STE 106
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011
Practice Address - Country:US
Practice Address - Phone:765-298-4926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-22
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10004502A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant