Debord Henriksen, Angela A
Debord Henriksen, Angela A is an individual health care provider with primary practice located at 1115 Ronald Reagan Pkwy Suite 318, Avon IN 46123-6914. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Debord Henriksen, Angela A can be contacted via phone (317) 217-2600.Contact Information
Primary practice address
1115 Ronald Reagan Pkwy Suite 318
Avon IN 46123-6914
Phone: (317) 217-2600
Fax: (317) 217-2606
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 01050868A | Indiana |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 01050868 | Indiana |
Profile Details
| NPI number | 1750321576 |
|---|---|
| LBN Legal business name | Debord Henriksen, Angela A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Jan 14th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750321576 | NPPES |
| Indiana | MEDICAID | 200338010 | |
| Indiana | Other | P00844459 |
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