ELISABETH K DEGENHARDT (NPI# 1508041716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508041716 |
| Entity Type | Individual |
| Full Name | ELISABETH K DEGENHARDT |
| Credential | RN, MSN |
| Practice Address |
5230 E Stop 11 Rd Ste 300 Indianapolis IN 46237-6401 |
| Mailing Address |
250 N Shadeland Ave Ste 130 Provider Enrollment Indianapolis IN 46219-4959 |
| Practice Telephone | 3177814588 |
| Practice Fax Number | 3177824885 |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2019-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
70000009C | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200980490 | 05 | |
| DEA# | MD1699199 | 01 | |
| IN | RN LICENSE | 28089558A | 01 |
| Street Address |
5230 E STOP 11 RD STE 300 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46237-6401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316571532 | Cameron Chappell | Nurse Practitioner | 5230 E Stop 11 Rd Ste 300, Indianapolis, IN 46237-6401 | 2020-02-26 |
| 1134601552 | Michelle Charlotte Mercier | Nurse Practitioner | 5230 E Stop 11 Rd Ste 300, Indianapolis, IN 46237-6401 | 2018-08-31 |
| 1225578909 | Kimberly Harter | Physician Assistant | 5230 E Stop 11 Rd Ste 300, Indianapolis, IN 46237-6401 | 2017-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568961902 | Ashley Marie Mitchell | Nurse Practitioner | 8111 S Emerson Ave # 101, Indianapolis, IN 46237 | 2018-02-11 |
| 1245692177 | Christopher W Gregory | Pharmacist | 8111 S Emerson Avenue, Indianapolis, IN 46237 | 2016-03-21 |
| 1558729111 | Franklin Point Dental | Clinic/Center | 6751 E Southport Rd, Suite H, Indianapolis, IN 46237 | 2016-02-10 |
| 1821460767 | Costco Wholesale Corporation | Pharmacy | 4628 E County Line Rd, Indianapolis, IN 46237 | 2015-10-29 |
| 1164894697 | Mercedes Castellanos-pitcock | Physician Assistant | 7855 S Emerson Ave Ste P, Indianapolis, IN 46237 | 2015-10-23 |
| 1013301142 | Sophia Frawley | Physical Therapist | 7855 South Emerson Avenue, Suite W, Indianepolis, IN 46237 | 2015-03-26 |
| 1154715829 | Emily Marie Prather | Specialist/Technologist | 4607 Citation Cir, Indianapolis, IN 46237 | 2015-03-20 |
| 1659794543 | Rachel Adams | Occupational Therapy Assistant | 6525 Moss Creek Place, Indianapolis, IN 46237 | 2014-01-28 |
| 1790121549 | Carol Lynn Patton | Nurse Practitioner | 8111 S Emerson Ave Fl 5, Indianapolis, IN 46237 | 2013-05-21 |
| 1255685772 | Jarron J Lincoln | Physician Assistant | 5230 E Stop 11 Rd Ste 250, Indianapolis, IN 46237 | 2012-11-06 |
| Find all providers in zip 46237 | ||||
| Taxonomy Code | 364SP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952603664 | Tara Elizabeth Gavardinas | Clinical Nurse Specialist | The Indiana Clinic, 340 W. 10th Street, Fs 5100, Indianapolis, IN 46202 | 2010-12-01 |
| 1407014327 | Regina Dawn Haight | Clinical Nurse Specialist | 1701 N Capitol Ave, C-3, Indianapolis, IN 46202-1203 | 2008-05-28 |
| 1245403419 | Carol Agnes Essenmacher | Clinical Nurse Specialist | 8075 N Shadeland Ave Ste 350, Indianapolis, IN 46250-2693 | 2008-04-09 |
| 1558308841 | Jennifer G Sims | Clinical Nurse Specialist | 1481 W 10th St # C-5085, Richard L Roudebush Va Medical Center, Indianapolis, IN 46202-2803 | 2006-06-02 |
| 1184676033 | Noreen M Nowak | Clinical Nurse Specialist | 1701 N. Senate Blvd, Ag022, Indianapolis, IN 46202 | 2006-05-17 |
| 1366944399 | Linda Demo | Clinical Nurse Specialist | 1500 N Ritter Ave, Indianapolis, IN 46219-3027 | 2018-03-06 |
| 1306254214 | Carrie Hatfield | Clinical Nurse Specialist | 5317 E 16th St, Indianapolis, IN 46218-4897 | 2014-07-24 |
| 1942593504 | Rosemary Elaine Freedman | Clinical Nurse Specialist | 7979 N Shadeland Ave, Indianapolis, IN 46250-2042 | 2011-05-16 |
| 1285812420 | Vicki Carol Dent | Clinical Nurse Specialist | 8320 Madison Ave, Indianapolis, IN 46227-6066 | 2008-02-08 |
| 1760502769 | Mary Patricia Hession | Clinical Nurse Specialist | 3307 W 96th St, Indianapolis, IN 46268-1106 | 2007-03-31 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46237 |
Please comment or provide details below to improve the information on ELISABETH K DEGENHARDT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.