Provider Demographics
NPI:1447099726
Name:ENGLISH, EBONY NICOLE
Entity type:Individual
Prefix:
First Name:EBONY
Middle Name:NICOLE
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8408 BOLERO WAY
Mailing Address - Street 2:
Mailing Address - City:CAMBY
Mailing Address - State:IN
Mailing Address - Zip Code:46113-8765
Mailing Address - Country:US
Mailing Address - Phone:317-331-4387
Mailing Address - Fax:
Practice Address - Street 1:8408 BOLERO WAY
Practice Address - Street 2:
Practice Address - City:CAMBY
Practice Address - State:IN
Practice Address - Zip Code:46113-8765
Practice Address - Country:US
Practice Address - Phone:317-331-4387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion