Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 2084P0802X | Psychiatry & Neurology | Addiction Psychiatry | | INDIANA | No |
| 2 | 2084P0804X | Psychiatry & Neurology | Child & Adolescent Psychiatry | | INDIANA | No |
| 3 | 363A00000X | Physician Assistant | | | INDIANA | No |
| 4 | 363LA2200X | Nurse Practitioner | Adult Health | | INDIANA | No |
| 5 | 208D00000X | General Practice | | | INDIANA | No |
| 6 | 363LF0000X | Nurse Practitioner | Family | | INDIANA | No |
| 7 | 207Q00000X | Family Medicine | | | INDIANA | No |
| 8 | 207R00000X | Internal Medicine | | | INDIANA | No |
| 9 | 2084N0400X | Psychiatry & Neurology | Neurology | | INDIANA | No |
| 10 | 363LG0600X | Nurse Practitioner | Gerontology | | INDIANA | No |
| 11 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | INDIANA | No |
| 12 | 364SP0808X | Clinical Nurse Specialist | Psychiatric/Mental Health | | INDIANA | No |
| 13 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | INDIANA | Yes |