NPI 1770626152

Southern Indiana Family Practice Center PC

Organisation Preferred Provider Organization Bloomington, IN

Practice location

Address: 3209 W Fullerton Pike STE a, Bloomington, IN 47403-4060
Phone: (812) 339-6744
Fax: (812) 671-9113

Authorised official

Name: Karen L. Reid-Renner
Title: Owner
Phone: (812) 339-6744

Registered specialties (2)

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 01055670A (IN)

Other Preferred Provider Organization providers in Indiana →

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363L00000X Licence 71002130A (IN)

Other Nurse Practitioner providers in Indiana →

Registry record

NPI: 1770626152
Entity type: Organization
NPI issued: 15 Feb 2007
Record last updated: 20 Nov 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.