Provider Demographics
NPI:1316785652
Name:GUILLEN, INNA AURELIA (MD)
Entity type:Individual
Prefix:
First Name:INNA
Middle Name:AURELIA
Last Name:GUILLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 E 65TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-2225
Mailing Address - Country:US
Mailing Address - Phone:574-221-9828
Mailing Address - Fax:
Practice Address - Street 1:2814 E 65TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-2225
Practice Address - Country:US
Practice Address - Phone:574-221-9828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program