Provider Demographics
NPI:1447554779
Name:GAINEY, MARLENA ANN (RNC-OB,WHNP-BC)
Entity type:Individual
Prefix:
First Name:MARLENA
Middle Name:ANN
Last Name:GAINEY
Suffix:
Gender:F
Credentials:RNC-OB,WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 E COUNTY LINE RD
Mailing Address - Street 2:SUITE W
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-0874
Mailing Address - Country:US
Mailing Address - Phone:317-887-4400
Mailing Address - Fax:317-887-4401
Practice Address - Street 1:1340 E COUNTY LINE RD
Practice Address - Street 2:SUITE W
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-0874
Practice Address - Country:US
Practice Address - Phone:317-887-4400
Practice Address - Fax:317-887-4401
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28159203A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN28159203AOtherRN LICENSE