Individual
LAURA A KILMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2477
(765) 448-8000
(765) 838-5150
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28238445A
IN
367500000X
Certified Registered Nurse Anesthetist
119182
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
28238445A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001139651
ANTHEM PROVIDER NUMBER
IN
05
—
300009674
—
IN
Enumeration date
08/04/2017
Last updated
02/17/2022
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