Individual
HOLLY M KIEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7979 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46250-2042
(317) 621-4300
(317) 621-4301
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71010164A
IN
363LP2300X
Primary Care Nurse Practitioner
71010164A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300040813
—
IN
Enumeration date
07/07/2020
Last updated
08/10/2020
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