Individual
KATELYNN DANIELLE CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 355-6900
Mailing address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28236182A
IN
363LF0000X
Family Nurse Practitioner
Primary
71014029A
IN
Other
Enumeration date
04/27/2023
Last updated
08/17/2023
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