Provider Demographics
NPI:1487279980
Name:VAN HOY, CARLI DANIELLE (NP)
Entity type:Individual
Prefix:
First Name:CARLI
Middle Name:DANIELLE
Last Name:VAN HOY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CARLI
Other - Middle Name:D
Other - Last Name:CHANDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11725 ILLINOIS ST STE 355
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3009
Practice Address - Country:US
Practice Address - Phone:317-688-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71010072A363LA2200X, 363LG0600X
IN28222545A363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300040945Medicaid
IN264431008OtherMEDICARE PTAN