Provider Demographics
NPI:1053923979
Name:FILOSA, JOHN ALEXANDER (FNP-C)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ALEXANDER
Last Name:FILOSA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8402 HARCOURT RD STE 125
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2094
Mailing Address - Country:US
Mailing Address - Phone:317-802-2000
Mailing Address - Fax:
Practice Address - Street 1:8402 HARCOURT RD STE 125
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2094
Practice Address - Country:US
Practice Address - Phone:317-802-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28227989A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner