| Doctor Name: | AUDREY R ALCALA |
| NPI Number: | 1508176892 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 71003418A |
| Business Practice Address: | 1515 S 19th St Elwood, IN - 460362941 |
| Business Phone Number: | 7655527346 |
| Business Fax Number: | 7655523351 |
| Mailing Address: | 6626 E 75th St, Suite 500 INDIANAPOLIS |
| State: | IN |
| Postal Code: | 462502890 |
| Phone Number: | 7652985280 |
| Fax Number: | 7655523351 |
| NPI Enumeration Date: | 10/20/2010 |
| NPI Last Update Date: | 03/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 71003418A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |