Individual
LAURA J KINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
355 W 16TH ST, SUITE 5100, INDIANAPOLIS, IN 46202
(317) 396-1300
(317) 924-8472
Mailing address
PO BOX 1329, BLOOMINGTON, IN 47402-1329
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28174769A
IN
363L00000X
Nurse Practitioner
Primary
71004069A
IN
Other
Enumeration date
07/25/2012
Last updated
08/29/2018
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