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Individual

KATIE M THOMPSON

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) 962-0582
(317) 962-2082
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
71013316A
IN
363L00000X
Nurse Practitioner
5010806
NC
363LA2200X
Adult Health Nurse Practitioner
1573
CO
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
71013316A
IN
363LG0600X
Gerontology Nurse Practitioner
71013316A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1101419885
ANTHEM PTAN
IN
01
233690176
MEDICARE
IN
05
300071639
IN
Enumeration date
07/26/2018
Last updated
06/18/2024
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