Provider Demographics
NPI:1780767186
Name:BIDDLE, ANN M (PA)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:BIDDLE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 7775985
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-5985
Mailing Address - Country:US
Mailing Address - Phone:317-770-6900
Mailing Address - Fax:317-770-6911
Practice Address - Street 1:18051 RIVER RD STE 200
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-7092
Practice Address - Country:US
Practice Address - Phone:317-773-0002
Practice Address - Fax:317-776-6095
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN10000499363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200900770Medicaid
INM400049899Medicare PIN
IN200900770Medicaid
970019580Medicare PIN
INP32806Medicare UPIN