Individual
MISTY MICHELLE KIRBY-NOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 963-1300
(317) 222-2012
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041239045
IL
363L00000X
Nurse Practitioner
71015402A
IN
363LA2200X
Adult Health Nurse Practitioner
209001928
IL
363LA2200X
Adult Health Nurse Practitioner
Primary
71015402A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068010A06
MEDICARE PTAN
IN
Enumeration date
03/05/2008
Last updated
07/19/2024
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