Provider Demographics
NPI:1982046587
Name:HOUSE, HILLARY A (APN)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:A
Last Name:HOUSE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:HILLARY
Other - Middle Name:A
Other - Last Name:CRAVENS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APN
Mailing Address - Street 1:6626 E 75TH STREET
Mailing Address - Street 2:STE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-621-7561
Mailing Address - Fax:317-355-6096
Practice Address - Street 1:2040 NORTH SHADELAND AVE
Practice Address - Street 2:STE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-1734
Practice Address - Country:US
Practice Address - Phone:317-355-1800
Practice Address - Fax:317-355-1803
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004469A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000834769OtherANTHEM BCBS
IN201184680Medicaid